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Organization
CENTRAL UTAH EYE ASSOCIATES
Active
Organization
CENTRAL UTAH EYE ASSOCIATES
Active
Other names
Excel Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE BLAKE (ADMINISTRATOR)
(801) 374-1818
Entity
Organization
Contact information
Practice address
1735 N STATE ST, PROVO, UT 84604-1010
(801) 374-1818
(801) 379-2959
Mailing address
1735 N STATE ST, PROVO, UT 84604-1010
(801) 374-1818
(801) 379-2959
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB6367
RAIL ROAD MEDICARE
UT
Enumeration date
07/16/2006
Last updated
08/26/2008
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