Healthcare Provider Details

I. General information

NPI: 1023220886
Provider Name (Legal Business Name): OGDEN VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 HARRISON BLVD
OGDEN UT
84403-1230
US

IV. Provider business mailing address

3475 HARRISON BLVD OGDEN VISION CENTER
OGDEN UT
84403-1230
US

V. Phone/Fax

Practice location:
  • Phone: 801-394-8885
  • Fax: 801-394-8991
Mailing address:
  • Phone: 801-394-8885
  • Fax: 801-394-8991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY C SLAUGH
Title or Position: OPTOMETRIST
Credential:
Phone: 801-394-8885