| Shoptikal Llc | |
|
1520 W 9000 S Ste E, West Jordan, UT 84088-8001 | |
| (801) 561-7300 | |
| Not Available |
| Full Name | Shoptikal Llc |
|---|---|
| Type | Facility |
| Speciality | Eyewear Supplier |
| Location | 1520 W 9000 S Ste E, West Jordan, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407412885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
| Provider Name | Steven Dewey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063462810 PECOS PAC ID: 5799797221 Enrollment ID: I20060626000179 |
| Provider Name | Scott R Haderlie |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386694677 PECOS PAC ID: 8820187925 Enrollment ID: I20071127000559 |
| Provider Name | Carlyle D Swain |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184725632 PECOS PAC ID: 1456696780 Enrollment ID: I20181214001166 |
| Provider Name | Karl Jepson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184976425 PECOS PAC ID: 2769790260 Enrollment ID: I20200617001541 |
| Provider Name | Ben Cannon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770868820 PECOS PAC ID: 6305061136 Enrollment ID: I20210301000646 |
| Provider Name | Michael W Davis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689670861 PECOS PAC ID: 9931261294 Enrollment ID: I20240812003068 |
| Mailing Address | Practice Location Address |
|---|---|
| Shoptikal Llc Po Box 19060, Green Bay, WI 54307-9060 Ph: () - | Shoptikal Llc 1520 W 9000 S Ste E, West Jordan, UT 84088-8001 Ph: (801) 561-7300 |