MEDICARE: SOUTHERN UTAH VISION CARE PLLC

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
1	261Q00000X	Clinic/Center
2	152W00000X	Optometrist

General Provider Information

NPI Number	:	1669978896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN UTAH VISION CARE PLLC

Provider Business Mailing Address
First Line	:	1251 NORTHFIELD RD STE 215
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-8623
Country	:	US
Telephone Number	:	435-865-7902
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 NORTHFIELD RD STE 215
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-8623
Country	:	US
Telephone Number	:	435-865-7902
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM SCOTT ALBRECHT
Credential	:	OD
Telephone Number	:	435-865-7902

Provider Enumeration Date	:	04/05/2018
Last Update Date	:	04/05/2018

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