Organization
RANDAL N ELLSWORTH M.D. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL NYLAN ELLSWORTH M.D. (OWNER)
(435) 656-2020
Entity
Organization
Contact information
Practice address
1791 E 280 N, SAINT GEORGE, UT 84790-2400
(435) 656-2020
(435) 673-4131
Mailing address
510 W 650 S, OREM, UT 84058-6136
(435) 656-2020
(435) 673-4131
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
274205-1205
UT
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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