Provider Demographics
NPI:1447135975
Name:DAVIS COUNTY GENERAL SURGERY
Entity type:Organization
Organization Name:DAVIS COUNTY GENERAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/MA
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:801-499-0247
Mailing Address - Street 1:440 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4950
Mailing Address - Country:US
Mailing Address - Phone:801-499-0247
Mailing Address - Fax:800-303-6743
Practice Address - Street 1:440 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4950
Practice Address - Country:US
Practice Address - Phone:801-499-0247
Practice Address - Fax:800-303-6743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty