Healthcare Provider Details

I. General information

NPI: 1821176132
Provider Name (Legal Business Name): CEDAR ANESTHESIA GROUP LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 N MAIN ST
CEDAR CITY UT
84720-9746
US

IV. Provider business mailing address

PO BOX 26063
SALT LAKE CITY UT
84126-0063
US

V. Phone/Fax

Practice location:
  • Phone: 435-868-5800
  • Fax:
Mailing address:
  • Phone: 435-255-7383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JOHN RONALD KILLPACK
Title or Position: PRESIDENT
Credential: CRNA
Phone: 435-531-6668