Provider Demographics
NPI:1063450435
Name:LOUIS MORALES JR., MD, PC
Entity Type:Organization
Organization Name:LOUIS MORALES JR., MD, PC
Other - Org Name:PLASTIC SURGERY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:801-743-0700
Mailing Address - Street 1:5089 S 900 E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5735
Mailing Address - Country:US
Mailing Address - Phone:801-743-0700
Mailing Address - Fax:801-743-0701
Practice Address - Street 1:5089 S 900 E
Practice Address - Street 2:SUITE 100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5735
Practice Address - Country:US
Practice Address - Phone:801-743-0700
Practice Address - Fax:801-743-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT169323208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty