Healthcare Provider Details

I. General information

NPI: 1487504908
Provider Name (Legal Business Name): BRUCE G EVANS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4624 S HOLLADAY BLVD STE 202
SALT LAKE CITY UT
84117-7168
US

IV. Provider business mailing address

1986 E FARM CIR
SANDY UT
84093-6296
US

V. Phone/Fax

Practice location:
  • Phone: 801-406-9601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BRUCE EVANS
Title or Position: CEO
Credential:
Phone: 801-406-9601