Provider Demographics
NPI:1689857302
Name:INSIGHT EYE CARE LLC
Entity type:Organization
Organization Name:INSIGHT EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HUEBNER
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:801-225-3920
Mailing Address - Street 1:1145 N 500 W STE A3
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3302
Mailing Address - Country:US
Mailing Address - Phone:801-225-3920
Mailing Address - Fax:801-225-1067
Practice Address - Street 1:1145 N 500 W STE A3
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3302
Practice Address - Country:US
Practice Address - Phone:801-225-3920
Practice Address - Fax:801-225-1067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6070270001Medicare NSC