Provider Demographics
NPI:1528085016
Name:MORRILL, DAVID KAY (OD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KAY
Last Name:MORRILL
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 1:102 W 1180 N STE 2
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-1492
Mailing Address - Country:US
Mailing Address - Phone:435-882-8439
Mailing Address - Fax:435-882-1914
Practice Address - Street 1:102 W 1180 N STE 2
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-1492
Practice Address - Country:US
Practice Address - Phone:435-882-8439
Practice Address - Fax:435-882-1914
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT284049-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT28404999302001OtherBCBS OF UT
UT268347OtherALTIUS
UT5751354OtherMAIL HANDLERS
UTQMP000003348309OtherMOLINA HEALTHCARE OF UTAH
UT1528085016Medicaid
UT203908830OtherGREAT WEST
UT203908830DVMOtherEDUCATORS MUTUAL
UT92871OtherPEHP
UT952069OtherDMBA
UT107052424101OtherSELECTHEALTH
UT203908830OtherUHC
UT48362OtherDAVIS VISION
UT48362OtherDAVIS VISION
UT1528085016Medicaid