Healthcare Provider Details

I. General information

NPI: 1235509654
Provider Name (Legal Business Name): EREK ROY WINNETT AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EREK WINNETT AUD

II. Dates (important events)

Enumeration Date: 09/28/2015
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8522 S 1300 E STE 108
SANDY UT
84094-1391
US

IV. Provider business mailing address

8522 S 1300 E STE 108
SANDY UT
84094-1391
US

V. Phone/Fax

Practice location:
  • Phone: 385-529-5603
  • Fax: 385-900-5460
Mailing address:
  • Phone: 385-529-5603
  • Fax: 385-900-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6945696-4101
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number6945696-4101
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: