Dr David D Mortensen, OD | |
2028 W 2220 N, Clinton, UT 84015-5744 | |
(801) 779-0708 | |
(385) 393-7875 |
Full Name | Dr David D Mortensen |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 2028 W 2220 N, Clinton, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871590430 | NPI | - | NPPES |
162686 | Other | VA | ANTHEM BLUE CROSS |
P00190241 | Other | VA | PALMETTO RAILROAD MEDICAR |
010118166 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 0601800582 (Virginia) | Secondary |
152W00000X | Optometrist | 361378-9934 (Utah) | Primary |
152W00000X | Optometrist | 18003429 A & B (Indiana) | Secondary |
Provider Name | Confederated Tribes Of The Goshute Reservation |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1750510277 PECOS PAC ID: 0042451650 Enrollment ID: O20130724000653 |
Mailing Address | Practice Location Address |
---|---|
Dr David D Mortensen, OD 2028 W 2220 N, Clinton, UT 84015-5744 Ph: (801) 779-0708 | Dr David D Mortensen, OD 2028 W 2220 N, Clinton, UT 84015-5744 Ph: (801) 779-0708 |
Clinton Family Vision Optometrist Medicare: Medicare Enrolled Practice Location: 1448 N 2000 W, Suite 12, Clinton, UT 84015 Phone: 801-779-0708 | |
National Vision Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1917 W 1800 N Ste D1, Clinton, UT 84015 Phone: 801-896-2952 | |
Victoria Nielsen, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 2028 W 2220 N, Clinton, UT 84015 Phone: 801-779-0708 | |
Dr. Gene L Christensen, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1632 N 2000w, Clinton, UT 84015 Phone: 801-779-3806 | |
Christensen Eyecare, Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1632 N 2000 W, Clinton, UT 84015 Phone: 801-779-3806 Fax: 801-779-3807 | |
Dr. Clark Edward Fielden, O.D. Optometrist Medicare: May Accept Medicare Assignments Practice Location: 2028 W 2220 N, Clinton, UT 84015 Phone: 801-779-0708 | |
Dr. Kendrick Lynn Garrett, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 1917 W 1800 N Ste D1, Clinton, UT 84015 Phone: 801-896-2952 |