# SANDMAN PHYSICIAN SERVICES PC

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

## Provider details

- **NPI number:** 1760814834
- **Authorized official:** DR. RICHARD L GLINES MD (PRESIDENT)
- **Authorized official phone:** (801) 209-7348

## Contact information

- **Practice address:** 637 SEGO LILY CIR, NORTH SALT LAKE, UT 84054-3355
- **Practice address phone:** (801) 209-7348
- **Mailing address:** 637 SEGO LILY CIR, NORTH SALT LAKE, UT 84054-3355

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 75964441205 | UT | Yes |
| 207LH0002X | Hospice and Palliative Medicine (Anesthesiology) Physician | 75964441205 | UT | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 75964441205 | UT | — |

## Other

- **Enumeration date:** 07/31/2013
- **Last updated:** 07/31/2013