Organization Name: | UTAH PODIATRY GROUP PC |
NPI Number: | 1831575760 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN MARIE TAYLOR (DIRECTOR OF OPERATIONS) |
Mailing Address: | 48 W 1500 N Nephi |
State: | UT US |
Postal Code: | 846488900 |
Phone Number: | 4356233200 |
Fax Number: | 8013735200 |
NPI Enumeration Date: | 08/03/2015 |
NPI Last Update Date: | 08/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |