Provider Demographics
NPI:1295490415
Name:EASTERN UTAH EYE PHYSICIANS
Entity type:Organization
Organization Name:EASTERN UTAH EYE PHYSICIANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-637-8689
Mailing Address - Street 1:200 N FAIRGROUNDS RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4228
Mailing Address - Country:US
Mailing Address - Phone:435-637-8689
Mailing Address - Fax:435-637-1126
Practice Address - Street 1:200 N FAIRGROUNDS RD STE 2
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4228
Practice Address - Country:US
Practice Address - Phone:435-637-8689
Practice Address - Fax:435-637-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty