Basic Information
| Provider Information | |||||||||
| NPI: | 1841618444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | INNES | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | WESTON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 N 1900 E RM 3C444 | ||||||||
| Address2: | DEPT OF ANESTHESIA | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841322501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015816393 | ||||||||
| FaxNumber: | 8015814367 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 W 800 N | ||||||||
| Address2: | STE 100 | ||||||||
| City: | OREM | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013737350 | ||||||||
| FaxNumber: | 8012245337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2014 | ||||||||
| LastUpdateDate: | 02/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 9538408-1205 | UT | N | Allopathic & Osteopathic Physicians | Anesthesiology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207LP2900X | 9538408-1205 | UT | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.