MD Center For Facial Rejuvenation
Clinic/Center, Ophthalmologic Surgery in Salt Lake City, UT. Organization (NPI-2).
NPI number1467520437
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1467520437
- Entity type
- Organization (NPI-2)
- Legal business name
- MD Center For Facial Rejuvenation
- Organization subpart
- No
- Enumeration date
- Nov 30, 2006
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QS0132X | Clinic/Center, Ophthalmologic Surgery | 6139294-1205 | UT | Yes |
Other names
- Renewmd (Doing Business As)
Practice location
6440 Wasatch BlvdSuite 390
Salt Lake City, UT 84121-3511
Phone 801-424-3223 · Fax 801-424-3228
Mailing address
6440 Wasatch BlvdSuite 390
Salt Lake City, UT 84121-3511
Phone 801-424-3223 · Fax 801-424-3228
Authorized official
Justin Rodney Johnsen
Owner
8014243223
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