Provider Demographics
NPI:1053473785
Name:DRUMMOND, RITA KARTINI (OD)
Entity type:Individual
Prefix:DR
First Name:RITA
Middle Name:KARTINI
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 HOMESTEAD RD STE 30
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-4874
Mailing Address - Country:US
Mailing Address - Phone:435-615-0435
Mailing Address - Fax:435-658-3094
Practice Address - Street 1:2700 HOMESTEAD RD STE 30
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-4874
Practice Address - Country:US
Practice Address - Phone:435-615-0435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11058TPG152W00000X
UT13396954-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist