Advanced Vein And Vascular Of Salt Lake City Llc | |
6321 S Redwood Rd Ste 102, Salt Lake City, UT 84123-6799 | |
(385) 388-8003 | |
(385) 344-4006 |
Full Name | Advanced Vein And Vascular Of Salt Lake City Llc |
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Type | Facility |
Speciality | Internal Medicine - Interventional Cardiology |
Location | 6321 S Redwood Rd Ste 102, Salt Lake City, Utah |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1386272755 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Secondary |
207RI0011X | Internal Medicine - Interventional Cardiology | (* (Not Available)) | Primary |
Provider Name | Christopher Yong-ku Kim |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1457650442 PECOS PAC ID: 8820276918 Enrollment ID: I20110620000279 |
Provider Name | Jennifer Ann Karr |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417272170 PECOS PAC ID: 4789956632 Enrollment ID: I20170828001694 |
Provider Name | Charles Scott Needham |
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Provider Type | Practitioner - Thoracic Surgery |
Provider Identifiers | NPI Number: 1063435899 PECOS PAC ID: 5597796383 Enrollment ID: I20210505000371 |
Provider Name | Scott Austin Butler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366118424 PECOS PAC ID: 5395141741 Enrollment ID: I20210909002565 |
Provider Name | Calen Powell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861072233 PECOS PAC ID: 7618374216 Enrollment ID: I20211116001243 |
Mailing Address | Practice Location Address |
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Advanced Vein And Vascular Of Salt Lake City Llc 6321 S Redwood Rd Ste 102, Salt Lake City, UT 84123-6799 Ph: (385) 388-8003 | Advanced Vein And Vascular Of Salt Lake City Llc 6321 S Redwood Rd Ste 102, Salt Lake City, UT 84123-6799 Ph: (385) 388-8003 |