Individual
DR. RICK NORDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1791 E 280 N, ST GEORGE, UT 84790-2400
(435) 656-2020
Mailing address
1791 E 280 N, SAINT GEORGE, UT 84790-2400
(435) 656-2020
(435) 634-2646
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01075209B
IN
207W00000X
Ophthalmology Physician
11363238-1205
UT
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
11363238-1205
UT
207WX0107X
Retina Specialist (Ophthalmology) Physician
19279
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201285680
—
IN
01
—
U000104096
MEDICARE
UT
Enumeration date
06/23/2011
Last updated
11/21/2019
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