1982759122 NPI number — HOOPES VISION CORRECTION CENTER, P.C.

Table of content: (NPI 1982759122)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982759122 NPI number — HOOPES VISION CORRECTION CENTER, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOOPES VISION CORRECTION CENTER, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982759122
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11820 S STATE ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DRAPER
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84020-7160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-568-0200
Provider Business Mailing Address Fax Number:
801-563-0200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11820 S STATE ST STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DRAPER
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84020-7160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-568-0200
Provider Business Practice Location Address Fax Number:
801-563-0200
Provider Enumeration Date:
01/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOOPES
Authorized Official First Name:
PHILLIP
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO/OWNER
Authorized Official Telephone Number:
801-568-0200

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: UT02430 . This is a "MEDICARE SUBMITTER ID" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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