Vance L. Fredrickson
Neurosurgeon
175 North Medical Drive East
Salt Lake City
, Utah 84132-0001
Vance L. Fredrickson
Neurosurgeon
175 North Medical Drive East
Salt Lake City
, Utah 84132-0001
(801) 581-6908
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About
Features
Specialties
- Neurosurgeon
Languages spoken
- English
Location
First Address
- Vance L. Fredrickson
- 175 North Medical Drive East
- Salt Lake City, UT
- Zip : 84132-0001
- Phone : (801) 581-6908
Second Address
- Vance L. Fredrickson
- 175 North Medical Drive East
- Salt Lake City, UT
- Zip : 84132-0001
- Phone : (801) 581-6908
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207T00000X | Neurosurgeon | 11725328-1205 | UT |
| N | 207T00000X | Neurosurgeon | 136637 | CA |
National Provider Identifier
| NPI | 1073957312 |
|---|---|
| Provider Name | Vance L. Fredrickson |
| First Address | Salt Lake City, UT 84132-0001 |
| Second Address | Salt Lake City, UT 84132-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/04/2013 |
| Last Update Date | 10/12/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.