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NPI Code Detail

MEDICARE: CYNTHIA LEE PAPADOPOULOS PAC

MEDICARE: CYNTHIA LEE PAPADOPOULOS PAC
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
1363A00000XPhysician Assistant8983549-1206UT
2363AM0700XMedical Physician Assistant8983549-1206UT

General Provider Information

NPI Number : 1639234016
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA LEE PAPADOPOULOS PAC
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-314-4300
Fax Number :
Provider Business Practice Location Address
First Line : 181 E MEDICAL TOWER DR
Second Line :
City : MURRAY
State : UT
Zip : 84107-4872
Country : US
Telephone Number : 801-413-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2006
Last Update Date : 06/28/2016

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Directions to “ CYNTHIA LEE PAPADOPOULOS PAC” Practice Location

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