# ERICKSON SURGICAL CONSULTING PLLC

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

## Provider details

- **NPI number:** 1558676957
- **Authorized official:** DR. TY BOLTON ERICKSON M.D. (M.D)
- **Authorized official phone:** (801) 727-2672

## Contact information

- **Practice address:** 10011 CENTENNIAL PKWY, SUITE 150, SANDY, UT 84070-4156
- **Practice address phone:** (801) 727-2672
- **Practice address fax:** (801) 727-2682
- **Mailing address:** 63 E 11400 S, SUITE 252, SANDY, UT 84070-6705
- **Mailing address phone:** (801) 727-2672
- **Mailing address fax:** (801) 727-2682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 63886701205 | UT | Yes |

## Other

- **Enumeration date:** 08/10/2010
- **Last updated:** 10/05/2011