| Clr Vision Pc | |
|
1675 N 200 W #11a, Provo, UT 84604-2570 | |
| (801) 374-2227 | |
| (801) 374-5197 |
| Full Name | Clr Vision Pc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1675 N 200 W #11a, Provo, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235304064 | NPI | - | NPPES |
| 461538993001 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 5950660-9943 (Utah) | Primary |
| Provider Name | Frank A Siddoway |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255343695 PECOS PAC ID: 4789586157 Enrollment ID: I20040127000297 |
| Provider Name | Chad Lewis Rigtrup |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821109059 PECOS PAC ID: 4880625870 Enrollment ID: I20050831000265 |
| Provider Name | Christopher John Jacob |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336520386 PECOS PAC ID: 3678885274 Enrollment ID: I20181101002606 |
| Mailing Address | Practice Location Address |
|---|---|
| Clr Vision Pc 1675 N 200 W #11a, Provo, UT 84604-2570 Ph: (801) 374-2227 | Clr Vision Pc 1675 N 200 W #11a, Provo, UT 84604-2570 Ph: (801) 374-2227 |
Trevor Todd Smith, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 320 River Park Dr Ste 245, Provo, UT 84604 Phone: 801-800-8508 | |
Dr. Andrew Timothy Smith, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2230 N University Pkwy Ste 10a, Provo, UT 84604 Phone: 801-373-4550 | |
Dr. Matthew Orgill, OD Optometrist Medicare: Medicare Enrolled Practice Location: 1800 Novell Pl, Provo, UT 84606 Phone: 801-375-5125 | |
Frank A Siddoway Od Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1675 N 200 W, #11-a, Provo, UT 84604 Phone: 801-374-2227 Fax: 801-374-5197 | |
Mr. David O. Edmunds, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1055 N 300 W Ste 204, Provo, UT 84604 Phone: 801-357-7373 Fax: 801-357-7217 | |
East Bay Eye Care Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1313 S University Ave, Provo, UT 84601 Phone: 801-377-9891 Fax: 801-356-6899 | |
Dr. Traer Gary Caywood, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1355 N University Ave, Suite 100, Provo, UT 84604 Phone: 801-377-4333 Fax: 801-370-3951 |