NPI 1164650685

Kevin Clifford Shosted, OD

Practitioner Optometrist Salt Lake City, UT

Practice location

Address: 2828 W 4700 S Suite D, Salt Lake City, UT 84118-2154
Phone: (801) 281-3937
Fax: (801) 281-1430

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 7385204-9934 (UT)

Other Optometrist providers in Utah →

Registry record

NPI: 1164650685
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jun 2009
Record last updated: 4 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.