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NPI Code Detail

MEDICARE: SCOTT C FRISCHKNECHT PA-C

MEDICARE: SCOTT C FRISCHKNECHT PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant101147-1206UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11013901792OTHERUTNPI

General Provider Information

NPI Number : 1013901792
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT C FRISCHKNECHT PA-C
Provider Business Mailing Address
First Line : 24 S 1100 E
Second Line : SUITE 101
City : SALT LAKE CITY
State : UT
Zip : 84102-1500
Country : US
Telephone Number : 801-355-6468
Fax Number : 801-355-3450
Provider Business Practice Location Address
First Line : 24 S 1100 E
Second Line : SUITE 101
City : SALT LAKE CITY
State : UT
Zip : 84102-1500
Country : US
Telephone Number : 801-355-6468
Fax Number : 801-355-3450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 09/02/2011

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Directions to “ SCOTT C FRISCHKNECHT PA-C” Practice Location

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