Individual
DR. MICHAEL MARK MONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
345 W 600 S STE 300, HEBER CITY, UT 84032-2268
(435) 654-1863
Mailing address
30 S 1970 E, HEBER CITY, UT 84032-4420
(406) 565-8298
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12983357-9934
UT
152W00000X
Optometrist
757 OPT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0483072
—
MT
05
—
121304100
—
WY
01
—
28091
BLUE CROSS BLUE SHIELD MT
MT
01
—
DB9976
RR MCR GROUP # (ODPC)
MT
05
—
OD 075 MT
—
AK
Enumeration date
09/27/2006
Last updated
05/31/2023
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