Provider Demographics
NPI:1417648494
Name:MEEK, TYLER (OD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:MEEK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12184 N BRIDGEGATE WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-5528
Mailing Address - Country:US
Mailing Address - Phone:385-200-2893
Mailing Address - Fax:
Practice Address - Street 1:60 S 200 E
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2412
Practice Address - Country:US
Practice Address - Phone:801-756-4731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13393973-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist