Organization
OCULOPLASTIC SURGERY, INC.
Active
Organization
OCULOPLASTIC SURGERY, INC.
Active
Other names
Still Canyon Eyelid & Facial Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS J J OBERG MD (PROVIDER/OWNER)
(801) 363-3356
Entity
Organization
Contact information
Practice address
5200 S HIGHLAND DR STE 201, HOLLADAY, UT 84117-7003
(801) 363-3356
(801) 533-9613
Mailing address
5200 S HIGHLAND DR STE 201, HOLLADAY, UT 84117-7003
(801) 363-3356
(801) 533-9613
Taxonomy
Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
464491680001
—
UT
05
—
479544679030
—
UT
05
—
485924851015
—
UT
Enumeration date
04/19/2007
Last updated
09/29/2023
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