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.
Organization
DEPARTMENT OF OPHTHALMOLOGY
Active
Organization
DEPARTMENT OF OPHTHALMOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL J OLSON MD (DEPARTMENT CHAIR)
(801) 587-6470
Entity
Organization
Contact information
Practice address
5126 W DAYBREAK PKWY, SOUTH JORDAN, UT 84095-5994
(801) 213-4500
Mailing address
PO BOX 413075, SALT LAKE CITY, UT 84141-3075
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
NULL
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
NULL
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
NULL
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
NULL
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
NULL
152WV0400X
Vision Therapy Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
—
NULL
152WX0102X
Occupational Vision Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers