Provider Demographics
NPI:1679733869
Name:SOUTHERN UTAH EAR NOSE & THROAT LLC
Entity type:Organization
Organization Name:SOUTHERN UTAH EAR NOSE & THROAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-628-3334
Mailing Address - Street 1:1490 E FOREMASTER DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4488
Mailing Address - Country:US
Mailing Address - Phone:435-628-3334
Mailing Address - Fax:435-628-3375
Practice Address - Street 1:1490 E FOREMASTER DR
Practice Address - Street 2:SUITE 350
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4488
Practice Address - Country:US
Practice Address - Phone:435-628-3334
Practice Address - Fax:435-628-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty