Organization
AVICENNA PC
Active
Other names
Avicenna Spine & Joint Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMON VOITANIK M.D. (OWNER)
(801) 942-6000
Entity
Organization
Contact information
Practice address
8706 S 700 E, SUITE 206, SANDY, UT 84070-1807
(801) 942-6000
(801) 748-4069
Mailing address
8706 S 700 E, SUITE 206, SANDY, UT 84070-1807
(801) 942-6000
(801) 748-4069
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2764211205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000059664
MEDICARE ID-PIN
UT
Enumeration date
11/17/2006
Last updated
07/28/2008
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