Organization
HANSEN-STULTS SURGICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK T HANSEN M.D. (PRESIDENT)
(435) 586-8192
Entity
Organization
Contact information
Practice address
166 W 1325 N, 350, CEDAR CITY, UT 84721-7792
(435) 586-8192
(435) 586-7564
Mailing address
166 W 1325 N, SUITE 350, CEDAR CITY, UT 84721-7792
(435) 586-8192
(435) 586-7564
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
3586141205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529966761002
—
UT
Enumeration date
03/21/2007
Last updated
11/22/2010
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