Southwick, Edward G

Southwick, Edward G is an individual health care provider with primary practice located at 3465 S 4155 W Suite #1, West Valley City UT 84120-2076. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Southwick, Edward G can be contacted via phone (801) 966-1403.

Contact Information

Primary practice address
3465 S 4155 W Suite #1 West Valley City UT 84120-2076
Phone: (801) 966-1403
Fax: (801) 964-6478
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 156560-1205 Utah
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 156560-1205 Utah
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 156560-1205 Utah

Profile Details

NPI number 1619957156
LBN Legal business name Southwick, Edward G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Aug 14th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619957156 NPPES
Utah Other 071157009 RAILROAD MEDICARE

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