Organization
THE SURGICARE CENTER OF UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN CRANDALL M.D. (PRESIDENT)
(801) 266-2283
Entity
Organization
Contact information
Practice address
755 E 3900 S, SALT LAKE CITY, UT 84107-2105
(801) 266-2283
(801) 268-6151
Mailing address
755 E 3900 S, SALT LAKE CITY, UT 84107-2105
(801) 266-2283
(801) 268-6151
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2004ASF276
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4900001440
RAILROAD MEDICARE
UT
05
—
GRP109526900
—
WY
Enumeration date
08/29/2006
Last updated
10/12/2009
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