Healthcare Provider Details

I. General information

NPI: 1174574800
Provider Name (Legal Business Name): VICTORIA L. KNUDSEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA MORRISON

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5169 S COTTONWOOD ST STE 630
SALT LAKE CITY UT
84107-6771
US

IV. Provider business mailing address

5169 S COTTONWOOD ST STE 630
SALT LAKE CITY UT
84107-6771
US

V. Phone/Fax

Practice location:
  • Phone: 801-312-2020
  • Fax: 801-312-2022
Mailing address:
  • Phone: 801-312-2020
  • Fax: 801-312-2022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number8041
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number6051574-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number6051574-1205
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA78941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: