Individual
RUSSELL LAMAR SORENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9844 S 1300 E, STE 250, SANDY, UT 84094-4691
(801) 571-1552
(801) 571-1562
Mailing address
9844 S 1300 E, STE 250, SANDY, UT 84094-4691
(801) 571-1552
(801) 571-1562
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1638911205
UT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
1638911205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1638911205
STATE LICENSE
UT
Enumeration date
06/01/2005
Last updated
09/11/2025
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