Individual
THOMAS LAMB CORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
INTERMOUNTAIN MEDICAL CENTER, 5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-3474
Mailing address
1414 E SHERMAN AVE, SALT LAKE CITY, UT 84105-2620
(970) 274-0799
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11037615-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11037615-1206
HOSPITAL
UT
Enumeration date
12/31/2018
Last updated
12/31/2018
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