Provider Demographics
NPI:1558472050
Name:R.G. NAYLOR SURGICAL, INC.
Entity Type:Organization
Organization Name:R.G. NAYLOR SURGICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:NAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-263-8511
Mailing Address - Street 1:1434 E. 4500 S.
Mailing Address - Street 2:#200
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84117
Mailing Address - Country:US
Mailing Address - Phone:801-263-8511
Mailing Address - Fax:801-266-7243
Practice Address - Street 1:1434 E. 4500 S.
Practice Address - Street 2:#200
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84117
Practice Address - Country:US
Practice Address - Phone:801-263-8511
Practice Address - Fax:801-266-7243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000060832Medicare PIN
UTCG0663Medicare PIN