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Individual

DAVID TEASLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1441 UTE BLVD, SUITE 220, PARK CITY, UT 84098-7630
(435) 647-5911
(435) 647-5930
Mailing address
1441 UTE BLVD, SUITE 220, PARK CITY, UT 84098-7630
(435) 647-5911
(435) 647-5930

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
6496301-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
059947
ANTHEM/HEALTHKEEPERS
VA
01
2477377
CIGNA
VA
01
51689
OPTIMA/SENTARA
VA
01
541397702
AETNA
VA
Enumeration date
07/25/2006
Last updated
01/11/2016
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