Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 12433934-1205 | UT |
N | 208200000X | Surgeon | 12433934-1205 | UT |
N | 208600000X | Surgeon | 12433934-1205 | UT |
NPI | 1003462136 |
---|---|
Provider Name | Dr. Philippe Paci |
First Address | Murray, UT 84107-5718 |
Second Address | Murray, UT 84107-5718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2019 |
Last Update Date | 06/10/2021 |