Healthcare Provider Details

I. General information

NPI: 1003665415
Provider Name (Legal Business Name): MICHAEL S BUXTON PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1399 S 700 E STE 11
SALT LAKE CITY UT
84105-2124
US

IV. Provider business mailing address

1399 S 700 E STE 11
SALT LAKE CITY UT
84105-2124
US

V. Phone/Fax

Practice location:
  • Phone: 801-318-1900
  • Fax:
Mailing address:
  • Phone: 801-318-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL S BUXTON
Title or Position: PH.D.
Credential: PH.D.
Phone: 801-318-1900