Provider Demographics
NPI:1891892063
Name:SHARON RICHENS MD EYE PHYSICIAN & SURGEON PC
Entity Type:Organization
Organization Name:SHARON RICHENS MD EYE PHYSICIAN & SURGEON PC
Other - Org Name:RICHENS EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-652-4040
Mailing Address - Street 1:161 W 200 N
Mailing Address - Street 2:STE 200
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2728
Mailing Address - Country:US
Mailing Address - Phone:435-652-4040
Mailing Address - Fax:435-652-4041
Practice Address - Street 1:161 W 200 N
Practice Address - Street 2:STE 200
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2728
Practice Address - Country:US
Practice Address - Phone:435-652-4040
Practice Address - Fax:435-652-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty