Healthcare Provider Details

I. General information

NPI: 1831987262
Provider Name (Legal Business Name): TREVOR RIGBY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N WASHINGTON BLVD
OGDEN UT
84404-3605
US

IV. Provider business mailing address

88 W 50 S UNIT R3
CENTERVILLE UT
84014-2360
US

V. Phone/Fax

Practice location:
  • Phone: 570-980-1394
  • Fax:
Mailing address:
  • Phone: 801-989-9619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number14264827-9934
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: