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Organization

MAYBIRD MEDICAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN MIDDLEMISS (REGISTERED AGENT)
(801) 641-7473
Entity
Organization

Contact information

Practice address
7085 S WATERMILL CIR, COTTONWOOD HEIGHTS, UT 84121-4328
(801) 641-7473
Mailing address
7085 S WATERMILL CIR, COTTONWOOD HEIGHTS, UT 84121-4328
(801) 641-7473

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
207T00000X
Neurological Surgery Physician
207X00000X
Orthopaedic Surgery Physician
207XS0117X
Orthopaedic Surgery of the Spine Physician
208600000X
Surgery Physician
2086S0127X
Trauma Surgery Physician
224Z00000X
Occupational Therapy Assistant
225100000X
Physical Therapist
225200000X
Physical Therapy Assistant
225X00000X
Occupational Therapist
246ZC0007X
Surgical Assistant
363A00000X
Physician Assistant
Primary
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
04/04/2023
Last updated
07/29/2023
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