Provider Demographics
NPI:1417773623
Name:UTAH WOUND SOLUTIONS PLLC
Entity type:Organization
Organization Name:UTAH WOUND SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:POPESCU
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:385-262-3211
Mailing Address - Street 1:450 S 400 E STE 724
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4938
Mailing Address - Country:US
Mailing Address - Phone:385-262-3211
Mailing Address - Fax:385-262-3211
Practice Address - Street 1:450 S 400 E STE 724
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4938
Practice Address - Country:US
Practice Address - Phone:385-262-3211
Practice Address - Fax:385-262-3211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty