MEDICARE: DARIN R. CUMMINGS 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	152W00000X	Optometrist	2846438904	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107008974104	OTHER	UT	SELECT HEALTH
2	328071	OTHER	UT	ALTIUS HEALTH PLANS
3	59306	OTHER	UT	PEHP
4	02846439903001	OTHER	UT	REGENCE BLUECROSS/BLUE SH
5	2004532	OTHER		UNITED HEALTHCARE
6	639164	OTHER		DESERET MUTUAL BENEFIT AD

General Provider Information

NPI Number	:	1306805007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARIN R. CUMMINGS O.D.

Provider Business Mailing Address
First Line	:	43 E 450 N
Second Line	:
City	:	EPHRAIM
State	:	UT
Zip	:	84627-4027
Country	:	US
Telephone Number	:	435-283-5555
Fax Number	:	435-283-8642

Provider Business Practice Location Address
First Line	:	43 E 450 N
Second Line	:
City	:	EPHRAIM
State	:	UT
Zip	:	84627-4027
Country	:	US
Telephone Number	:	435-283-5555
Fax Number	:	435-283-8642

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	01/19/2012

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