Healthcare Provider Details

I. General information

NPI: 1083890388
Provider Name (Legal Business Name): RESORT MEDICAL SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 N. HWY 143
BRIAN HEAD UT
84719-0285
US

IV. Provider business mailing address

PO BOX 190285
BRIAN HEAD UT
84719-0285
US

V. Phone/Fax

Practice location:
  • Phone: 435-677-2700
  • Fax: 435-677-2700
Mailing address:
  • Phone: 435-677-2700
  • Fax: 435-677-2700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberNONE
License Number State

VIII. Authorized Official

Name: MICHAEL G. MCMAHAN
Title or Position: MANAGER
Credential: PA-C
Phone: 435-677-2700