MEDICARE: THOMAS L CURETON 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
1	363AS0400X	Surgical Physician Assistant	7870839-1206	UT

General Provider Information

NPI Number	:	1578566154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS L CURETON PA-C

Provider Business Mailing Address
First Line	:	280 S MAIN ST
Second Line	:
City	:	BOUNTIFUL
State	:	UT
Zip	:	84010-6236
Country	:	US
Telephone Number	:	801-505-0821
Fax Number	:	801-505-0803

Provider Business Practice Location Address
First Line	:	1160 E 3900 S STE 4050
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-1264
Country	:	US
Telephone Number	:	801-262-8486
Fax Number	:	801-284-8699

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	09/06/2023

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