Provider Demographics
NPI:1083328850
Name:ALDER, ANTHONY CHARLES (PA-C, DMS)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHARLES
Last Name:ALDER
Suffix:
Gender:M
Credentials:PA-C, DMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 W 4100 S STE 107
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-6063
Mailing Address - Country:US
Mailing Address - Phone:385-402-7500
Mailing Address - Fax:
Practice Address - Street 1:3725 W 4100 S STE 107
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84120-6063
Practice Address - Country:US
Practice Address - Phone:385-402-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical