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Individual

DR. LELAND RUSSEL CHICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1220 E 3900 S STE 4I, SALT LAKE CITY, UT 84124-1383
(801) 322-1188
(801) 363-1847
Mailing address
24 S 1100 E, STE 201, SALT LAKE CITY, UT 84102-1500
(801) 322-1188
(801) 363-1847

Taxonomy

Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
89-180960-1205
UT
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
89-180960-1205
UT

Other

Enumeration date
03/21/2007
Last updated
07/21/2022
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