Provider Demographics
NPI:1154438182
Name:VEATER, RHETT D (OD)
Entity type:Individual
Prefix:
First Name:RHETT
Middle Name:D
Last Name:VEATER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10857 WEISS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-7748
Mailing Address - Country:US
Mailing Address - Phone:801-217-8973
Mailing Address - Fax:270-956-0180
Practice Address - Street 1:1656 W 9000 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9222
Practice Address - Country:US
Practice Address - Phone:801-255-5454
Practice Address - Fax:801-255-1109
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5682080-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1157738182OtherMARCH VISION
UT1154438182Medicaid
UT000063745Medicare PIN
UTP00617876Medicare PIN
UT1154438182Medicaid
KYVAD000Medicare UPIN