Provider Demographics
NPI:1083890388
Name:RESORT MEDICAL SERVICES P.C.
Entity Type:Organization
Organization Name:RESORT MEDICAL SERVICES P.C.
Other - Org Name:BRIAN HEAD MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCMAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:435-677-2700
Mailing Address - Street 1:PO BOX 190285
Mailing Address - Street 2:
Mailing Address - City:BRIAN HEAD
Mailing Address - State:UT
Mailing Address - Zip Code:84719-0285
Mailing Address - Country:US
Mailing Address - Phone:435-677-2700
Mailing Address - Fax:435-677-2700
Practice Address - Street 1:365 N. HWY 143
Practice Address - Street 2:
Practice Address - City:BRIAN HEAD
Practice Address - State:UT
Practice Address - Zip Code:84719-0285
Practice Address - Country:US
Practice Address - Phone:435-677-2700
Practice Address - Fax:435-677-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care