Organization
MOUNTAIN WEST ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY MITCHELL BAILEY MD (PRESIDENT)
(435) 649-1346
Entity
Organization
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7850
Mailing address
PO BOX 3570, SALT LAKE CITY, UT 84110-3570
(801) 727-2056
(770) 701-6675
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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