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General NPI Number Information
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NPI Number | 1093850885
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Entity Type | Organization
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Legal Business Name | CANCER AND BLOOD INSTITUTE OF SOUTHERN UTAH INC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 544 S 400 E
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City | SAINT GEORGE
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State | UT
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Zip | 84770-3705
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Country | US
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Telephone | 435-986-9369
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Fax | 435-986-9368
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Provider Business Mailing Address
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Address Line | 544 S 400 E
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City | SAINT GEORGE
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State | UT
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Zip | 84770-3705
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Country | US
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Telephone | 435-986-9369
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Fax | 435-986-9368
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Authorized Official
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Title or Position | PRESIDENT
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Name | DON LYNN DAVIS
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Credential |
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Telephone | 435-986-9369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 6079303-1205
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License Number State | UT
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