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CORAL DESERT SPINE SURGERY NPI 1376839902


NPI Information

NPI: 1376839902
Provider Name: CORAL DESERT SPINE SURGERY
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1490 E FOREMASTER DR STE 220
ST GEORGE, UT
ZIP 84790
Phone: (435) 656-8366
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CORAL DESERT SPINE SURGERY is a specialist in St George, UT. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. CORAL DESERT SPINE SURGERY NPI is 1376839902. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1490 E FOREMASTER DR STE 220
ST GEORGE, UT
ZIP 84790-498
Phone: (435) 656-8366
Fax: (435) 656-8370

The provider's authorized official is Ryan D Church .
The authorized official title is Owner and has the following contact phone number (435) 656-8366.

The enumeration date for this NPI number is 6/22/2011 and was last updated on 9/11/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist5064080-1205UTAHYes

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

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