Provider Demographics
NPI:1669978896
Name:SOUTHERN UTAH VISION CARE PLLC
Entity type:Organization
Organization Name:SOUTHERN UTAH VISION CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ALBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:435-865-7902
Mailing Address - Street 1:1251 NORTHFIELD RD STE 215
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-8623
Mailing Address - Country:US
Mailing Address - Phone:435-865-7902
Mailing Address - Fax:
Practice Address - Street 1:1251 NORTHFIELD RD STE 215
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-8623
Practice Address - Country:US
Practice Address - Phone:435-865-7902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty