Provider Demographics
NPI:1790348449
Name:SUMMIT EYE CENTER
Entity Type:Organization
Organization Name:SUMMIT EYE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:N
Authorized Official - Last Name:CAPSTICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:612-308-0679
Mailing Address - Street 1:7456 S PARKRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-4834
Mailing Address - Country:US
Mailing Address - Phone:801-878-6151
Mailing Address - Fax:801-999-7552
Practice Address - Street 1:7001 S 900 E STE 200
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-6067
Practice Address - Country:US
Practice Address - Phone:801-878-6151
Practice Address - Fax:801-999-7552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty