MEDICARE: RUSSELL PURDY OD

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	152W00000X	Optometrist	113333-9934	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
2	241764	OTHER	UT	DMBA

General Provider Information

NPI Number	:	1295823029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSSELL PURDY OD

Provider Business Mailing Address
First Line	:	1901 PARKWAY BLVD
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84119-2001
Country	:	US
Telephone Number	:	801-886-2020
Fax Number	:	801-954-0054

Provider Business Practice Location Address
First Line	:	1076 LAYTON HILLS MALL STE 2090
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-2104
Country	:	US
Telephone Number	:	801-546-0255
Fax Number	:	801-546-0260

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/16/2008

Similar Medicare Providers

1760583298 — STANDARD OPTICAL CO
Practice Location Address:

1076 LAYTON HILLS MALL , SUITE 2090
LAYTON, UT
84041-2104

Practice Phone: 801-546-0255
Practice Fax: 801-546-0260

1083489504 — BRIGHTER STRIDES ABA UT LLC
Practice Location Address:

1536 WOODLAND PARK DR STE 230
LAYTON, UT
84041-5750

Practice Phone: 980-317-8260
Practice Fax:

1831022631 — LAUREN BISHOP
Practice Location Address:

372 W GORDON AVE
LAYTON, UT
84041-4485

Practice Phone: 801-452-1940
Practice Fax:

1508682139 — HANNAH JARVIS PA-C
Practice Location Address:

2121 N 1700 W
LAYTON, UT
84041-8803

Practice Phone: 801-773-4840
Practice Fax:

1285326843 — ANGELA ROSE
Practice Location Address:

1133 N MAIN ST
LAYTON, UT
84041-4800

Practice Phone: 801-663-6109
Practice Fax:

1174526107 — OPEN IMAGING-LAYTON, LLC
Practice Location Address:

2071 N MAIN ST STE 100
LAYTON, UT
84041-4970

Practice Phone: 801-825-4040
Practice Fax: 801-825-4039

Directions to “ RUSSELL PURDY OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.