Organization
EASTERN UTAH SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY E HANSEN M.D. (MEDICAL DIRECTOR)
(435) 637-1744
Entity
Organization
Contact information
Practice address
200 N FAIRGROUNDS RD, SUITE 1, PRICE, UT 84501-4205
(435) 637-1744
(435) 637-1123
Mailing address
200 N FAIRGROUNDS RD, SUITE 1, PRICE, UT 84501-4205
(435) 637-1744
(435) 637-1123
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
5249970-1704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20034276600001
BCBS PROVIDER NUMBER
UT
Enumeration date
11/13/2006
Last updated
06/05/2008
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