Organization
BOUNTIFUL SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL H TODD MD (PRESIDENT)
(801) 298-1123
Entity
Organization
Contact information
Practice address
425 MEDICAL DRIVE #101, BOUNTIFUL, UT 84010
(801) 298-1123
(801) 292-1271
Mailing address
425 MEDICAL DRIVE #101, BOUNTIFUL, UT 84010
(801) 298-1123
(801) 292-1271
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
03/04/2008
Last updated
03/07/2008
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