# LONE PEAK ANESTHESIA LC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083622641
- **Authorized official:** J. TODD NILSON MD (PRESIDENT)
- **Authorized official phone:** (800) 594-5736

## Contact information

- **Practice address:** 150 W CIVIC CENTER DR, SUITE 200, SANDY, UT 84070-4230
- **Practice address phone:** (801) 432-2677
- **Practice address fax:** (678) 285-6777
- **Mailing address:** PO BOX 3810, SALT LAKE CITY, UT 84110-3810
- **Mailing address phone:** (800) 594-5736
- **Mailing address fax:** (678) 285-6777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 01/27/2016