Provider Demographics
NPI:1538345830
Name:RESORT MEDICAL SERVICES, P.C.
Entity type:Organization
Organization Name:RESORT MEDICAL SERVICES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCMAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:435-772-3226
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84767-0248
Mailing Address - Country:US
Mailing Address - Phone:435-772-3226
Mailing Address - Fax:435-772-3226
Practice Address - Street 1:120 LION BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:UT
Practice Address - Zip Code:84767-0248
Practice Address - Country:US
Practice Address - Phone:435-772-3226
Practice Address - Fax:435-772-3226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care