# PHYSICIANS SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1356395586
- **Authorized official:** KEVIN H. CHARLTON M.D. (M.D. MANAGER - MEMBER)
- **Authorized official phone:** (801) 277-2062

## Contact information

- **Practice address:** 1485 E 3900 S, SALT LAKE CITY, UT 84124-1412
- **Practice address phone:** (801) 277-2062
- **Practice address fax:** (801) 274-3233
- **Mailing address:** 1485 E 3900 S, SALT LAKE CITY, UT 84124-1412
- **Mailing address phone:** (801) 277-2062
- **Mailing address fax:** (801) 274-3233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2006-ASF-74408 | UT | Yes |

## Other

- **Enumeration date:** 05/20/2006
- **Last updated:** 07/08/2014