MEDICARE: DR. DEVIN ACEL DUVAL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WP0200X	Pediatric Optometrist	9042285-9934	UT
2	152WS0006X	Sports Vision Optometrist	9042285-9934	UT
3	152WV0400X	Vision Therapy Optometrist	9042285-9934	UT
4	152W00000X	Optometrist	9042285-9934	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164834834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEVIN ACEL DUVAL O.D.

Provider Business Mailing Address
First Line	:	309 W 100 S
Second Line	:
City	:	OREM
State	:	UT
Zip	:	84058-5493
Country	:	US
Telephone Number	:	801-800-8508
Fax Number	:	801-800-8508

Provider Business Practice Location Address
First Line	:	320 RIVER PARK DR STE 245
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-6065
Country	:	US
Telephone Number	:	801-800-8508
Fax Number	:	385-595-0195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2014
Last Update Date	:	01/18/2024

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