Provider Demographics
NPI:1184471567
Name:MICHAEL S BUXTON PHD
Entity type:Organization
Organization Name:MICHAEL S BUXTON PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BUXTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-318-1900
Mailing Address - Street 1:1399 S 700 E STE 11
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2124
Mailing Address - Country:US
Mailing Address - Phone:801-318-9000
Mailing Address - Fax:
Practice Address - Street 1:1399 S 700 E STE 11
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2124
Practice Address - Country:US
Practice Address - Phone:801-318-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health