Basic Information
Provider Information | |||||||||
NPI: | 1114991429 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LINTON | ||||||||
FirstName: | NORMAN | ||||||||
MiddleName: | KENT | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1172 E 100 N | ||||||||
Address2: | SUITE 4 | ||||||||
City: | PAYSON | ||||||||
State: | UT | ||||||||
PostalCode: | 846511667 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8014652575 | ||||||||
FaxNumber: | 8014650629 | ||||||||
Practice Location | |||||||||
Address1: | 1735 N STATE ST | ||||||||
Address2: |   | ||||||||
City: | PROVO | ||||||||
State: | UT | ||||||||
PostalCode: | 846041010 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8013741818 | ||||||||
FaxNumber: | 8013740163 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/14/2006 | ||||||||
LastUpdateDate: | 09/16/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 1704971205 | UT | Y |   | Allopathic & Osteopathic Physicians | Ophthalmology |   |
ID Information
ID | Type | State | Issuer | Description | 870283576L12 | 01 | UT | EDUCATORS MUTUAL | OTHER | 107006677103 | 01 | UT | SELECT | OTHER | 1772785005 | 01 | UT | CIGNA | OTHER | 36274 | 01 | UT | DMBA | OTHER | 0800374 | 01 | UT | UNITED HEALTHCARE | OTHER | 107006677103 | 01 | UT | HEALTH CHOICE | OTHER | QM0000052273 | 01 | UT | ALTIUS | OTHER | 107006677103 | 01 | UT | QUEST | OTHER |