Individual
COULSON DIRK BOGGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
PA-C
Contact information
Practice address
900 ROUND VALLEY DR STE 100, PARK CITY, UT 84060-7552
(435) 655-6600
(435) 655-2388
Mailing address
900 ROUND VALLEY DR STE 100, PARK CITY, UT 84060-7552
(435) 655-6600
(435) 655-2388
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14268687-1206
UT
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/18/2025
Last updated
03/04/2026
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