Provider Demographics
NPI:1760569651
Name:UNGRICHT PARKER EYE ASSOCIATES INC
Entity Type:Organization
Organization Name:UNGRICHT PARKER EYE ASSOCIATES INC
Other - Org Name:UNGRICHT PARKER EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:UNGRICHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-314-4420
Mailing Address - Street 1:5770 S 250 E
Mailing Address - Street 2:SUITE 410
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-8100
Mailing Address - Country:US
Mailing Address - Phone:801-314-4420
Mailing Address - Fax:801-314-4421
Practice Address - Street 1:5770 S 250 E
Practice Address - Street 2:SUITE 410
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8100
Practice Address - Country:US
Practice Address - Phone:801-314-4420
Practice Address - Fax:801-314-4421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000055161Medicare PIN