Provider Demographics
NPI:1063296317
Name:UGHETTO, MEGAN ANN (COA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:UGHETTO
Suffix:
Gender:F
Credentials:COA
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Mailing Address - Street 1:4521 THOMAS JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-5100
Mailing Address - Country:US
Mailing Address - Phone:208-454-4820
Mailing Address - Fax:208-454-4857
Practice Address - Street 1:4521 THOMAS JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5100
Practice Address - Country:US
Practice Address - Phone:208-454-4820
Practice Address - Fax:208-454-4857
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant