NPI 1104018308 · live from the CMS NPI Registry
Carl Van Gils, Dpm, PC
Podiatrist in Panguitch, UT. National Provider Identifier 1104018308, active.
NPI record
| NPI | 1104018308 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 25 N 300 West, Panguitch, UT 84759 |
| Practice phone | 435-632-6682 |
| Mailing address | 31 S Reflection Way, St George, UT 84770 |
| Enumerated | August 13, 2007 |
| Last updated | August 13, 2007 |
| Authorized official | Carl Van Gils, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 3739380501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.