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Contact Information

AVICENNA PC
8706 S 700 E
SUITE 206
SANDY, UT84070-1807
 Phone: 801-942-6000
 Fax: 801-748-4069
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for AVICENNA PC · (Female)

NPI Number 1952475410
Status Active
Credentials
Entity Individual
Enumeration date 11/17/2006
Last updated 07/28/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • UT License # 2764211205
  • UT Other 000059664 MEDICARE ID-PIN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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