# CENTRAL UTAH EYE ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Excel Eye Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992722888
- **Authorized official:** MR. DALE BLAKE (ADMINISTRATOR)
- **Authorized official phone:** (801) 374-1818

## Contact information

- **Practice address:** 1735 N STATE ST, PROVO, UT 84604-1010
- **Practice address phone:** (801) 374-1818
- **Practice address fax:** (801) 379-2959
- **Mailing address:** 1735 N STATE ST, PROVO, UT 84604-1010
- **Mailing address phone:** (801) 374-1818
- **Mailing address fax:** (801) 379-2959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 08/26/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CB6367 | RAIL ROAD MEDICARE | UT |