EYE PROS OF LOGAN LLC (NPI# 1043702046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043702046 |
| Entity Type | Organization |
| Organization Name | EYE PROS OF LOGAN LLC |
| Other Organization Name | EYE PROS |
| Practice Address |
1475 N Main St Ste 103 Logan UT 84341 |
| Mailing Address |
3485 N Cole Rd Unit 45479 Boise ID 83711-1095 |
| Practice Telephone | 2085018222 |
| Mailing Telephone | 2082977019 |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2020-10-01 |
| Authorized Official Name | MR. LAVAR WENDELL KOFOED (OWNER) |
| Authorized Official Telephone | 2084479965 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Eye Pros | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6128 W Fairview Ave Ste 2a, Boise, ID 837045000 | 2083787020 | |
| 1475 N Main St Ste 100, Logan, UT 843412682 | 2082977019 | 2082977518 |
| Street Address |
1475 N MAIN ST STE 103 |
| City | LOGAN |
| State | UT |
| Zip Code | 84341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962995456 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1475 N Main St Ste 103, Logan, UT 84341-2598 | 2018-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| 1891073334 | Jake Daniel Sorensen | Dentist | 40 W. Cache Valley Blvd. #2a, Logan, UT 84341 | 2011-08-02 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821615352 | Hocking Hills Eye Care LLC | Optometrist | 31630 Chieftain Dr, Logan, OH 43138-9087 | 2020-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1689970667 | Michael Wayne Cole | Optometrist | 981s Main St 220, Logan, UT 84321-6055 | 2011-02-08 |
| 1225330673 | Northern Utah Eye Center | Optometrist | 550 E 1400 N Ste T, Logan, UT 84341-2407 | 2010-11-17 |
| 1154506012 | Eye Care for You P.C. | Optometrist | 43 E 400 N, Logan, UT 84321-4020 | 2008-01-09 |
| 1881762342 | Lucas Eye Care Pllc | Optometrist | 113 Lb and T Way, Logan, WV 25601-3485 | 2006-12-01 |
| 1265501027 | Milton C Mason | Optometrist | 498 W Hunter St, Logan, OH 43138-1105 | 2006-11-07 |
| 1104902428 | Arabel E Hatfield | Optometrist | 148 Enterprise Dr, Logan, WV 25601-3753 | 2006-10-29 |
| 1396833000 | S Louis Berta | Optometrist | 15171 Burcham Rd, Logan, OH 43138-8995 | 2006-10-10 |
| 1215038724 | Standard Optical Co | Optometrist | 1153 N Main St, Suite A120, Logan, UT 84341-2495 | 2006-09-26 |
| Find all providers in LOGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.