Provider Demographics
NPI:1841386745
Name:MOUNTAIN VIEW EYE CENTER
Entity Type:Organization
Organization Name:MOUNTAIN VIEW EYE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANSLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-773-2233
Mailing Address - Street 1:1580 W ANTELOPE DR STE 175
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1175
Mailing Address - Country:US
Mailing Address - Phone:801-773-2233
Mailing Address - Fax:801-773-2375
Practice Address - Street 1:1580 W ANTELOPE DR STE 175
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1175
Practice Address - Country:US
Practice Address - Phone:801-773-2233
Practice Address - Fax:801-773-2375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000055284OtherMEDICARE PTAN
UT0945710001Medicare NSC