Healthcare Provider Details

I. General information

NPI: 1255447538
Provider Name (Legal Business Name): WILLIAM L SAUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N 500 E SUITE 320
LOGAN UT
84341-2408
US

IV. Provider business mailing address

PO BOX 27128
SLC UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 435-755-8200
  • Fax: 435-752-6094
Mailing address:
  • Phone: 435-755-8200
  • Fax: 435-752-6094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number92-187154-1205
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier060016794
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerRR MEDICARE
# 2
Identifier53176
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerDESERET MUTUAL
# 3
Identifier87-0569381
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerTAX ID
# 4
Identifier27611
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerPEHP
# 5
Identifier107005240101
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerSELECTCARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: