MEDICARE: NEUROSURGICAL CLINIC OF UTAH

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
1	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1508852641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROSURGICAL CLINIC OF UTAH

Provider Business Mailing Address
First Line	:	24 S 1100 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1500
Country	:	US
Telephone Number	:	801-531-7806
Fax Number	:	801-355-5566

Provider Business Practice Location Address
First Line	:	24 S 1100 E
Second Line	:	SUITE 302
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1500
Country	:	US
Telephone Number	:	801-531-7806
Fax Number	:	801-355-5566

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT S HOOD
Credential	:	MD
Telephone Number	:	801-531-7806

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	08/20/2007

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