Organization
SOUTH EASTERN UTAH PATHOLOGY PLCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEO WILLIAM HARDY M.D. (CORP PRESIDENT)
(435) 637-8358
Entity
Organization
Contact information
Practice address
1588 N COAL CREEK RD, PRICE, UT 84501-7615
(435) 637-8358
Mailing address
1588 N COAL CREEK RD, PRICE, UT 84501-7615
(435) 637-8358
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
188453-1205
UT
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
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Other
Enumeration date
12/28/2012
Last updated
01/03/2013
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