Provider Demographics
NPI:1467858951
Name:ONSYTE SURGICAL, LLC
Entity Type:Organization
Organization Name:ONSYTE SURGICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-663-3332
Mailing Address - Street 1:90 W 500 S # 605
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6230
Mailing Address - Country:US
Mailing Address - Phone:801-663-3332
Mailing Address - Fax:855-236-8404
Practice Address - Street 1:1262 S 650 W STE 1D
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-4606
Practice Address - Country:US
Practice Address - Phone:801-663-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT908544-0162261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical