MEDICARE: CEDAR SURGICAL ASSOCIATES LC

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	261QA1903X	Ambulatory Surgical Clinic/Center	EXEMPT	UT

General Provider Information

NPI Number	:	1447267554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDAR SURGICAL ASSOCIATES LC

Provider Business Mailing Address
First Line	:	1811 W ROYAL HUNTE DR STE 3
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-8352
Country	:	US
Telephone Number	:	435-586-3402
Fax Number	:	435-867-4945

Provider Business Practice Location Address
First Line	:	1811 W ROYAL HUNTE DR STE 3
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-8352
Country	:	US
Telephone Number	:	435-586-3402
Fax Number	:	435-867-4945

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. CHAD W ANDERSON
Credential	:	M.D.
Telephone Number	:	435-586-3402

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	03/26/2014

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