Healthcare Provider Details
I. General information
NPI: 1356270987
Provider Name (Legal Business Name): EPIC EYE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35 S 1050 E
HYDE PARK UT
84318-3587
US
IV. Provider business mailing address
35 S 1050 E
HYDE PARK UT
84318-3587
US
V. Phone/Fax
- Phone: 801-618-8251
- Fax:
- Phone: 801-618-8251
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KARL
THOMAS
JEPSON
Title or Position: OPTOMETRIST
Credential: OD
Phone: 801-618-8251