Organization
DEPT OF OPHTHALMOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL OLSON M.D (DEPARTMENT CHAIR)
(801) 581-3195
Entity
Organization
Contact information
Practice address
65 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84132-0001
(801) 581-3195
Mailing address
PO BOX 413075, SALT LAKE CITY, UT 84141-3075
(801) 581-3195
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
09/11/2007
Last updated
11/07/2012
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