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NPI Code Detail

MEDICARE: DR. CALLIN PASSEY OD

MEDICARE: DR. CALLIN PASSEY OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist5199756-9934UT

General Provider Information

NPI Number : 1508020363
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CALLIN PASSEY OD
Provider Business Mailing Address
First Line : 517 W 100 N STE 210
Second Line :
City : PROVIDENCE
State : UT
Zip : 84332-9826
Country : US
Telephone Number : 435-755-6061
Fax Number : 994-836-2509
Provider Business Practice Location Address
First Line : 517 W 100 N STE 110
Second Line :
City : PROVIDENCE
State : UT
Zip : 84332-9826
Country : US
Telephone Number : 435-755-6075
Fax Number : 435-374-0502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2008
Last Update Date : 08/12/2022

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