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Organization
SOUTH EASTERN UTAH PATHOLOGY PLCC
Active
Organization
SOUTH EASTERN UTAH PATHOLOGY PLCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEO WILLIAM HARDY M.D. (CORP PRESIDENT)
(435) 637-8358
Entity
Organization
Contact information
Practice address
1588 N COAL CREEK RD, PRICE, UT 84501-7615
(435) 637-8358
Mailing address
1588 N COAL CREEK RD, PRICE, UT 84501-7615
(435) 637-8358
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
188453-1205
UT
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
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Other
Enumeration date
12/28/2012
Last updated
01/03/2013
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