Organization
VINCENT SURGICAL ARTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DRAKE G VINCENT M.D. (MEDICAL DIRECTOR)
(801) 942-1111
Entity
Organization
Contact information
Practice address
6710 S BLACKSTONE RD, SUITE 201, COTTONWOOD HEIGHTS, UT 84121-6072
(801) 942-1111
(801) 942-1188
Mailing address
6710 S BLACKSTONE RD, SUITE 201, COTTONWOOD HEIGHTS, UT 84121-6072
(801) 942-1111
(801) 942-1188
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
5767298-8905
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5828175-0160
BUSINESS ENTITY
UT
Enumeration date
06/11/2014
Last updated
06/11/2014
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