Healthcare Provider Details
I. General information
NPI: 1528098662
Provider Name (Legal Business Name): KEITH NEIL FINLAYSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/04/2006
Last Update Date: 12/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
389 S 900 E
SALT LAKE CITY UT
84102-2310
US
IV. Provider business mailing address
PO BOX 27128
SALT LAKE CITY UT
84127-0128
US
V. Phone/Fax
- Phone: 385-282-2000
- Fax: 385-282-2001
- Phone: 801-535-8163
- Fax: 801-355-4011
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 159368-1205 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: