Provider Demographics
NPI:1790086379
Name:CANYON MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:CANYON MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-444-9940
Mailing Address - Street 1:1940 S 1600 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3868
Mailing Address - Country:US
Mailing Address - Phone:480-444-9940
Mailing Address - Fax:801-665-1513
Practice Address - Street 1:1940 S 1600 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3868
Practice Address - Country:US
Practice Address - Phone:480-444-9940
Practice Address - Fax:801-665-1513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251G00000X, 261Q00000X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No251G00000XAgenciesHospice Care, Community Based
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center