# NORTHERN UTAH ENDOSCOPY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northern Utah Endoscopy Center, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902875669
- **Authorized official:** DR. DUANE BOHMAN MD (MEMBER)
- **Authorized official phone:** (435) 787-0270

## Contact information

- **Practice address:** 630 E 1400 N, SUITE 100A, LOGAN, UT 84341-2534
- **Practice address phone:** (435) 787-0270
- **Practice address fax:** (435) 787-0262
- **Mailing address:** 630 E 1400 N, SUITE 100A, LOGAN, UT 84341-2534
- **Mailing address phone:** (435) 787-0270
- **Mailing address fax:** (435) 787-0262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2006-ASF-16794 | UT | Yes |

## Other

- **Enumeration date:** 03/15/2006
- **Last updated:** 04/28/2011