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:
Health care specialties
| Specialty | Code | License # | 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 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619957156 | NPPES |
| Utah | Other | 071157009 | RAILROAD MEDICARE |
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