Individual
NATHAN A POULSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8TH AVENUE C ST E, SALT LAKE CITY, UT 84143-2360
(801) 498-1100
Mailing address
PO BOX 3570, SALT LAKE CITY, UT 84110-3570
(801) 727-2056
(770) 701-6675
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12052769-1205
UT
207L00000X
Anesthesiology Physician
MT191516
PA
Other
Enumeration date
07/10/2007
Last updated
10/25/2021
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