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Individual
DR. RICK NORDGREN
Active
Individual
DR. RICK NORDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01075209B
IN
207W00000X
Ophthalmology Physician
11363238-1205
UT
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
11363238-1205
UT
207WX0107X
Retina Specialist (Ophthalmology) Physician
19279
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201285680
—
IN
01
—
U000104096
MEDICARE
UT
Enumeration date
06/23/2011
Last updated
11/21/2019
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