Provider Type Icon

LAKEVIEW NEUROSURGERY CLINIC LLC NPI 1619919396


NPI Information

NPI: 1619919396
Provider Name: LAKEVIEW NEUROSURGERY CLINIC, LLC
Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
620 MEDICAL DR
SUITE 300
BOUNTIFUL, UT
ZIP 84010
Phone: (801) 299-3871
Get Directions

LAKEVIEW NEUROSURGERY CLINIC, LLC is a neurological surgery in Bountiful, UT. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. LAKEVIEW NEUROSURGERY CLINIC, LLC NPI is 1619919396. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

620 MEDICAL DR
SUITE 300
BOUNTIFUL, UT
ZIP 84010-908
Phone: (801) 299-3871

The provider's authorized official is Jeff Rydburg .
The authorized official title is Vp and has the following contact phone number (801) 299-3871.

The enumeration date for this NPI number is 6/10/2006 and was last updated on 8/27/2008.


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
1207T00000XNeurological SurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DF9134MEDICARE PIN
2000059534MEDICARE PINUTAH

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

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.