DR. CHARLES C SOUTHERLAND DPM NPI 1306832944

NPI Information

NPI: 1306832944
Provider Name: DR. CHARLES C SOUTHERLAND, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
3435 E PONY EXPRESS PKWY STE 140
EAGLE MOUNTAIN, UT
ZIP 84005
Phone: (801) 893-8811
Get Directions

DR. Charles C Southerland, DPM is a foot and ankle surgery podiatrist in Eagle Mountain, UT. DR. Charles C Southerland, DPM NPI is 1306832944. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3435 E PONY EXPRESS PKWY STE 140
EAGLE MOUNTAIN, UT
ZIP 84005-548
Phone: (801) 893-8811

The NPI 1306832944 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 9/20/2005 and was last updated on 4/24/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	9244891-0501	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9244891-0501	OTHER	UTAH	MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »