Provider Demographics
NPI:1831688738
Name:SHARON RICHENS MD EYE PHYSICIAN & SURGEON PC
Entity type:Organization
Organization Name:SHARON RICHENS MD EYE PHYSICIAN & SURGEON PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-674-0832
Mailing Address - Street 1:161 W 200 N STE 200
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-7386
Mailing Address - Country:US
Mailing Address - Phone:435-986-2020
Mailing Address - Fax:435-652-1516
Practice Address - Street 1:161 W 200 N STE 200
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-7386
Practice Address - Country:US
Practice Address - Phone:435-986-2020
Practice Address - Fax:435-652-1516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty