Organization
OLYMPUS VALLEY SURGICAL ASSOICATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MARIE VAUGHN (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
1220 E 3900 S STE 4E, SALT LAKE CITY, UT 84124-1343
(973) 251-1132
Mailing address
PO BOX 99130, LAS VEGAS, NV 89193-9130
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0127X
Trauma Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/02/2016
Last updated
10/16/2023
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