Healthcare Provider Details
I. General information
NPI: 1831182799
Provider Name (Legal Business Name): ZION EYE INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2005
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1791 E 280 N
ST GEORGE UT
84790-2463
US
IV. Provider business mailing address
1791 E 280 N
ST GEORGE UT
84790-2463
US
V. Phone/Fax
- Phone: 435-656-2020
- Fax: 435-673-4131
- Phone: 435-656-2020
- Fax: 435-673-4131
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QS0132X |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| License Number | 3020 |
| License Number State | UT |
VIII. Authorized Official
Name: MR.
ZACHARY
COX
Title or Position: ADMINISTRATOR
Credential:
Phone: 435-656-2020