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Dr. Charles C Southerland, DPM
Foot & Ankle Surgery Podiatrist in Eagle Mountain, Utah
NPI 1306832944

Charles C Southerland is a Foot & Ankle Surgery Podiatrist based in Miami Shores, UT and is specialized in Foot & Ankle Surgery. Charles C Southerland practices in Eagle Mountain, UT and has the professional credentials of DPM. The NPI Number for Charles C Southerland is 1306832944 and holds a License No. 9244891-0501 (Utah).

The current practice location address for Charles C Southerland is 3435 E Pony Express Pkwy Ste 140, Eagle Mountain, UT and can be reached out via phone at 801-893-8811.

Location: 3435 E Pony Express Pkwy Ste 140, Eagle Mountain, UT, 33161
person
Provider Profile Details
NPI Number
1306832944
Provider Name
Charles C Southerland
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
3435 E Pony Express Pkwy Ste 140, Eagle Mountain, UT, 33161
Phone Number
801-893-8811
Fax Number
Provider Enumeration Date
09/20/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9244891-0501 01 UT MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
3435 E Pony Express Pkwy Ste 140
City
State
Zip
84005-5548
Phone Number
801-893-8811
Fax Number
person
Provider Business Mailing Address Details
Address
3435 E Pony Express Pkwy Ste 140
City
State
Zip
84005-5548
Phone Number
801-893-8811
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
9244891-0501 (Utah)
Definition
Definition to come...
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