Dr Edward G Southwick, MD is a
Dermatology physician based in West Valley City, Utah. Dr Edward G Southwick is licensed to practice in Utah (license number 156560-1205) and his current practice location is 3465 S 4155 W, Suite #1, West Valley City, Utah. He can be reached at his office (for appointments etc.) via phone at
(801) 966-1403.
NPI number for Dr Edward G Southwick is 1619957156 and his current mailing address is 3465 South 4155 West, Suite #1, West Valley City, Utah. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619957156.
Physician's Profile
| Full Name | Dr Edward G Southwick |
|---|
| Gender | Male |
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| Speciality | Dermatology |
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| Location | 3465 S 4155 W, West Valley City, Utah |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1619957156
- Provider Enumeration Date: 01/19/2006
- Last Update Date: 08/14/2012
Medical Identifiers
Medical identifiers for Dr Edward G Southwick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619957156 | NPI | - | NPPES |
| 071157009 | Other | UT | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 156560-1205 (Utah) | Primary |
| 207ND0900X | Dermatology - Dermatopathology | 156560-1205 (Utah) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | 156560-1205 (Utah) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Edward G Southwick is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Edward G Southwick, MD
3465 South 4155 West, Suite #1,
West Valley City, UT 84120-2077
Ph: (801) 966-1403 | Dr Edward G Southwick, MD
3465 S 4155 W, Suite #1,
West Valley City, UT 84120-2076
Ph: (801) 966-1403 |
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