Organization Name: | ERICKSON SURGICAL CONSULTING PLLC |
NPI Number: | 1558676957 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TY BOLTON ERICKSON (M.D) |
Mailing Address: | 10011 Centennial Pkwy Suite 150 Sandy |
State: | UT US |
Postal Code: | 840704156 |
Phone Number: | 8017272672 |
Fax Number: | 8017272682 |
NPI Enumeration Date: | 08/10/2010 |
NPI Last Update Date: | 10/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 63886701205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |