Provider Demographics
NPI:1144838004
Name:ANESTHESIOLOGY ASSOCIATES OF UTAH LLC
Entity type:Organization
Organization Name:ANESTHESIOLOGY ASSOCIATES OF UTAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-663-3332
Mailing Address - Street 1:1649 S 200 E
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2033
Mailing Address - Country:US
Mailing Address - Phone:801-663-3332
Mailing Address - Fax:801-716-7889
Practice Address - Street 1:5450 S GREEN ST STE B
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-5632
Practice Address - Country:US
Practice Address - Phone:801-663-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1245258342Medicaid