National Provider Identifier Database

AVICENNA PC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


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
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for AVICENNA PC

NPI Number 1952475410
Legal business name
LBN
AVICENNA PC
Authorized official SIMON VOITANIK - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/17/2006
Last updated 07/28/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • UT License #: 2764211205
  • UT Other: 000059664 MEDICARE ID-PIN

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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