# U OF U ROCKY MOUNTAIN OPHTHALMOLOGY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831134519
- **Authorized official:** RANDALL J OLSON MD (DEPARTMENT CHAIR)
- **Authorized official phone:** (801) 581-3195

## Contact information

- **Practice address:** 4400 S 700 E, SALT LAKE CITY, UT 84107-3000
- **Practice address phone:** (801) 264-4464
- **Mailing address:** 4400 S 700 E, SALT LAKE CITY, UT 84107-3000
- **Mailing address phone:** (801) 264-4464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 152WP0200X | Pediatric Optometrist | — | NULL | — |
| 152WP0200X | Pediatric Optometrist | — | — | — |
| 156FC0800X | Contact Lens Technician/Technologist | — | NULL | — |
| 156FC0800X | Contact Lens Technician/Technologist | — | — | — |
| 156FC0801X | Contact Lens Fitter | — | NULL | — |
| 156FC0801X | Contact Lens Fitter | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 09/06/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 114230500 | WYOMING MEDICAID | WY |
| 01 | — | 807025800 | IDAHO MEDICAID | ID |