PREMIER PLASTIC SURGERY GROUP OF UTAH NPI 1689906976

NPI Information

NPI: 1689906976
Provider Name: PREMIER PLASTIC SURGERY GROUP OF UTAH
Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
11762 S STATE ST STE 220
DRAPER, UT
ZIP 84020
Phone: (801) 571-2020
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PREMIER PLASTIC SURGERY GROUP OF UTAH is a plastic and reconstructive surgery surgery in Draper, UT. The provider is a surgeon who specializes in plastic and reconstructive surgery. PREMIER PLASTIC SURGERY GROUP OF UTAH NPI is 1689906976. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11762 S STATE ST STE 220
DRAPER, UT
ZIP 84020-156
Phone: (801) 571-2020
Fax: (801) 571-6899

The provider's authorized official is Stephanie White .
The authorized official title is Secretary and has the following contact phone number (801) 571-2020.

The enumeration date for this NPI number is 2/11/2010 and was last updated on 1/19/2011.

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	2086S0122X	Surgery	Plastic and Reconstructive Surgery			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
1	529316986001	MEDICAID	UTAH
2	528276851028	MEDICAID	UTAH
3	UT03528	MEDICARE PIN	UTAH
4	000057752	MEDICARE PIN	UTAH
5	000062982	MEDICARE PIN
6	005775201	MEDICARE PIN	UTAH

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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