Individual
DR. COURT RUSSELL WILKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4360 WASHIGHTON BLVD, OGDEN, UT 84403
(801) 476-0494
Mailing address
1873 S 1030 W, OREM, UT 84058-8141
(928) 899-6527
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
04409T
TX
152W00000X
Optometrist
Primary
7793397-9974
UT
152WC0802X
Corneal and Contact Management Optometrist
04409T
TX
152WP0200X
Pediatric Optometrist
04409T
TX
152WV0400X
Vision Therapy Optometrist
04409T
TX
152WX0102X
Occupational Vision Optometrist
04409T
TX
Other
Enumeration date
09/16/2005
Last updated
05/31/2024
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