Provider Demographics
NPI:1508052234
Name:DOUGLAS S. MEHR, M.D., P.C.
Entity Type:Organization
Organization Name:DOUGLAS S. MEHR, M.D., P.C.
Other - Org Name:SALT LAKE RETINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-260-0034
Mailing Address - Street 1:3855 W 7800 S
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5560
Mailing Address - Country:US
Mailing Address - Phone:801-260-0034
Mailing Address - Fax:801-260-0035
Practice Address - Street 1:9643 CHANNING DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-2818
Practice Address - Country:US
Practice Address - Phone:801-302-0723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty