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Organization
WEST VALLEY EYE LLC
Active
Organization
WEST VALLEY EYE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E SMITH M.D. (OWNER)
(801) 965-3636
Entity
Organization
Contact information
Practice address
3725 W 4100 S, WEST VALLEY CITY, UT 84120-5530
(801) 965-3636
(801) 965-3559
Mailing address
3527 WEST 4100 SOUTH, WEST VALLEY CITY, UT 84120-5530
(801) 965-3636
(801) 965-3559
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
359975-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14490
SPECTERA
UT
01
—
352130
DMBA
UT
05
—
5283309*93016
—
UT
01
—
UT9975
EYE MED
UT
Enumeration date
09/08/2006
Last updated
08/22/2020
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