Marty, Michael
Marty, Michael is an individual health care provider with primary practice located at 6525 S State St C/O Optical, Murray UT 84107-7218. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Marty, Michael can be contacted via phone (801) 685-7989.Contact Information
Primary practice address
6525 S State St C/O Optical
Murray UT 84107-7218
Phone: (801) 685-7989
Fax: (801) 685-9105
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2774349934 | Utah |
Profile Details
| NPI number | 1497743942 |
|---|---|
| LBN Legal business name | Marty, Michael |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Apr 22nd, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497743942 | NPPES |
| Utah | MEDICAID | 999000797009 | |
| Utah | Other | 87017934007001 |
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