| Southwest Vision, Llc | |
|
415 E Center St, Panguitch, UT 84759-0976 | |
| (435) 676-8646 | |
| (435) 676-8647 |
| Full Name | Southwest Vision, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 415 E Center St, Panguitch, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366883936 | NPI | - | NPPES |
| 528352394017 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 5679342-9934 (Utah) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Vision, Llc 965 E 700 S, Suite #100, St George, UT 84790-4082 Ph: (435) 673-5577 | Southwest Vision, Llc 415 E Center St, Panguitch, UT 84759-0976 Ph: (435) 676-8646 |
Dr. Shane Jensen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 415 E. Center Street, Panguitch, UT 84759 Phone: 435-676-8646 Fax: 435-676-8646 | |
Shane R Jensen Optometrist Medicare: Not Enrolled in Medicare Practice Location: 415 East Center Street, Panguitch, UT 84759 Phone: 435-676-8646 Fax: 435-676-8646 |