Organization
PHYSICIANS SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN H. CHARLTON M.D. (M.D. MANAGER - MEMBER)
(801) 277-2062
Entity
Organization
Contact information
Practice address
1485 E 3900 S, SALT LAKE CITY, UT 84124-1412
(801) 277-2062
(801) 274-3233
Mailing address
1485 E 3900 S, SALT LAKE CITY, UT 84124-1412
(801) 277-2062
(801) 274-3233
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2006-ASF-74408
UT
Other
Enumeration date
05/20/2006
Last updated
07/08/2014
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