IndividualActive
Blaine Bird, O.D.
NPI 1871581652 · Optometrist · Provo, UT
Provider details
- NPI number
- 1871581652
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 114554-8908 (UT)
Specialties & taxonomies
Eye and Vision Services Providers
Eye and Vision Services Providers
Eye and Vision Services Providers
Eye and Vision Services Providers
Practice location
1055 N 300 W
Suite 204
Provo, UT 84604-3344
Phone: (801) 357-7373
Fax: (801) 357-7217
Approximate (ZIP-level) locationGet directions
Mailing address
1055 N 300 W
Provo, UT 84604-3344
Registry dates
- Enumerated
- 2005-10-06
- Last updated
- 2020-06-10
- Certified
- 2020-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.