MEDICARE: WESTERN UROLOGICAL CLINIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		UT

General Provider Information

NPI Number	:	1386699676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN UROLOGICAL CLINIC PC

Provider Business Mailing Address
First Line	:	4252 HIGHLAND DR
Second Line	:	#200
City	:	SLC
State	:	UT
Zip	:	84124-2670
Country	:	US
Telephone Number	:	801-993-1800
Fax Number	:	801-993-1699

Provider Business Practice Location Address
First Line	:	4252 HIGHLAND DR
Second Line	:	#200
City	:	SLC
State	:	UT
Zip	:	84124-2670
Country	:	US
Telephone Number	:	801-993-1800
Fax Number	:	801-993-1699

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. LANE C CHILDS
Credential	:	M.D.
Telephone Number	:	801-993-1800

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/21/2022

Similar Medicare Providers

1902847940 — DR. PETER C. FISHER M.D.
Practice Location Address:

4252 HIGHLAND DR , #200
SLC, UT
84124-2670

Practice Phone: 801-993-1800
Practice Fax: 801-993-1699

1831239995 — DR. LANE C. CHILDS MD
Practice Location Address:

4252 HIGHLAND DR , #200
SLC, UT
84124-2670

Practice Phone: 801-993-1800
Practice Fax: 801-993-1699

1790825768 — DR. STEVEN N. GANGE MD
Practice Location Address:

4252 HIGHLAND DR , #200
SLC, UT
84124-2670

Practice Phone: 801-993-1800
Practice Fax: 801-993-1699

1114115862 — ELIZABETH LEEANNE DARLING PA-C MPAS
Practice Location Address:

4252 HIGHLAND DR , #200
SLC, UT
84124-2670

Practice Phone: 801-993-1800
Practice Fax: 801-993-1699

1073048195 — SALT CITY WELLNESS, PLLC
Practice Location Address:

2670 S 2000 E
SLC, UT
84109-1782

Practice Phone: 801-960-2550
Practice Fax: 801-550-9757

1831133891 — DR. DOUGLAS H. HOWE D.D.S.
Practice Location Address:

4252 HIGHLAND DR , SUITE 103
SALT LAKE CITY, UT
84124-2670

Practice Phone: 801-274-2034
Practice Fax: 801-274-2106

Directions to “WESTERN UROLOGICAL CLINIC PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.