Dallas Stevens
Dallas Stevens is an Optometry in Rexburg, Idaho. Graduated from Pacific Medical College in 2009, 17 years ago. Practices with Luke A. Randall PLLC, a 2-clinician group and accepts Medicare assignment. Licensed in Idaho.
- Years since qualifying
- 17
- Trained at
- Pacific Medical College
- Licensed in
- ID
- In the registry since
- 2008
Practice location Address checks out
1232 PleasantviewRexburg, ID 83440-5316
Phone: (208) 709-7314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Optometrist (primary) | Taxonomy 152W00000X · Licence ODP-100186 (ID) |
|---|
Record details
| NPI number | 1174775332 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | October 21, 2008 |
| Last updated in NPPES | May 1, 2020 |
| Certification date | May 1, 2020 |
| Mailing address | 4255 W Sugarberry Ct, Eagle, ID 83616-7266 |
Medicare enrollment
| Medicare specialty | OPTOMETRY |
|---|---|
| Medical school | PACIFIC MEDICAL COLLEGE |
| Graduated | 2009 (17 years in practice) |
| Group practice | Luke A. Randall Pllc — 2 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
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Damon Scott Mortensen, OD
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Dr. H. Scott Mortensen III, OD
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Dr. Nathan Cody Mortensen, OD
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Rexburg Vision Center
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