Organization
UNIVERSITY NEUROSURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM T COULDWELL MD (DEPT CHAIR)
(801) 581-6909
Entity
Organization
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0100
(801) 581-6909
(801) 581-4385
Mailing address
50 N MEDICAL DR, #3B409-SOM, SALT LAKE CITY, UT 84132-0100
(801) 581-6909
(801) 581-4385
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100502572
—
NV
05
—
122555300
—
WY
05
—
805967200
—
ID
05
—
807419000
—
ID
Enumeration date
09/16/2006
Last updated
09/06/2011
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