| Roy Raymond Gibson, OD | |
|
4949 S 900 W, Riverdale, UT 84405-3777 | |
| (801) 621-0480 | |
| (801) 612-3485 |
| Full Name | Roy Raymond Gibson |
|---|---|
| Gender | Male |
| Speciality | Optometry |
| Experience | 40 Years |
| Location | 4949 S 900 W, Riverdale, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104816743 | NPI | - | NPPES |
| 1737499 | Other | UT | FIRST HEALTH NETWORK |
| 589803 | Other | UT | DMBA |
| 11445324 | Other | UT | CAQH |
| 81820 | Other | UT | PEHP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1130289934 (Utah) | Primary |
| 152W00000X | Optometrist | 1130288904 (Utah) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Eye Pros Of Layton Llc | 1355680851 | 3 |
| Eye Pros Of Ogden | 6901142025 | 2 |
| Provider Name | Eye Pros Of Logan Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1043702046 PECOS PAC ID: 9335497254 Enrollment ID: O20180808002189 |
| Provider Name | Eye Pros Of Ogden |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1710456975 PECOS PAC ID: 6901142025 Enrollment ID: O20190110002752 |
| Provider Name | Eye Pros Of Layton Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1760956221 PECOS PAC ID: 1355680851 Enrollment ID: O20190227002921 |
| Mailing Address | Practice Location Address |
|---|---|
| Roy Raymond Gibson, OD 5690 S 3750 W, Roy, UT 84067-8161 Ph: (801) 985-4141 | Roy Raymond Gibson, OD 4949 S 900 W, Riverdale, UT 84405-3777 Ph: (801) 621-0480 |
Dr. David Boyle Burnett, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 4848 S 900 W, Riverdale, UT 84405 Phone: 801-627-9868 Fax: 801-627-9870 | |
Eyecare Wellness Clinic P.l.l.c. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4848 S 900 W, Riverdale, UT 84405 Phone: 801-627-9868 Fax: 801-627-9870 | |
Shopko Stores Operating Co. Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4060 Riverdale Rd, Riverdale, UT 84405 Phone: 801-392-4300 | |
Eye Pros Of Ogden Optometrist Medicare: Medicare Enrolled Practice Location: 4115 Riverdale Rd, Riverdale, UT 84405 Phone: 208-297-7019 | |
Boster Vision, Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4848 S 900 W, Riverdale, UT 84405 Phone: 801-404-2825 |