Walter S Medlin MD PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WALTER S MEDLIN MD PC

Practice address

1046 E 100 S Ste a
Salt Lake City, UT 84102-1520

Phone

(801) 746-2885

Fax

(801) 746-2886

NPI assigned

Jul 10, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Walter Scott Edwards Medlin

Title

Owner

Phone

(406) 238-2500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Mooers, M.D.

  • Surgery Physician
  • Salt Lake City, UT
  • NPI 1225417280
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1699327684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 E 100 S # A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021520",
            "telephone_number": "855-655-7389",
            "fax_number": "801-931-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 E 100 S STE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021520",
            "telephone_number": "801-746-2885",
            "fax_number": "801-746-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER S MEDLIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "MEDLIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "SCOTT EDWARDS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-238-2500"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Byrnes Walsh, NP
• Joshua Palmer Walsh, PHARMD
• Kane Thomas Walsh, M.D.
• Ryan McLean Walsh, PA-C
• Sarena Kim Walsh
• Christopher Steven Walter, PT, DPT
• Brooke Walters, RDN
• Carly Rose Walters
• Jessica Walters
• Sara Alecia Walters

• Surgery Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.