Provider Demographics
NPI:1992446447
Name:MONSON SURGICAL CENTERS LLC
Entity type:Organization
Organization Name:MONSON SURGICAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-787-7200
Mailing Address - Street 1:810 S 100 W STE A
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-6093
Mailing Address - Country:US
Mailing Address - Phone:435-787-7200
Mailing Address - Fax:
Practice Address - Street 1:810 S 100 W STE A
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-6093
Practice Address - Country:US
Practice Address - Phone:435-787-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery