| Medical Neuroscience | |
|
50 N Medical Dr Salt Lake City UT 84132-0001 | |
| (801) 581-2121 | |
| (801) 581-4385 |
| Full Name | Medical Neuroscience |
|---|---|
| Speciality | Physical Medicine & Rehabilitation - Pain Medicine |
| Location | 50 N Medical Dr, Salt Lake City, Utah |
| Authorized Official Name and Position | William T Couldwell (DEPT CHAIR) |
| Authorized Official Contact | 8015816909 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Neuroscience 50 N Medical Dr U Of U Som Dept Of Neurosurgery #3b409 Salt Lake City UT 84132-0001 Ph: (801) 581-6909 | Medical Neuroscience 50 N Medical Dr Salt Lake City UT 84132-0001 Ph: (801) 581-2121 |
| NPI Number | 1225135106 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 09/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225135106 | NPI | - | NPPES |
| 118163700 | Medicaid | WY | |
| 806539400 | Medicaid | ID | |
| 100503241 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | (* (Not Available)) | Primary |
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