Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Olympus Valley Surgical Assoicates PLLC

Organization Surgery Physician · NPI 1164965570

Olympus Valley Surgical Assoicates PLLC is a Surgery Physician in Salt Lake City, Utah. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1220 E 3900 S Ste 4E
Salt Lake City, UT 84124-1343
Phone: (973) 251-1132
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X
Trauma Surgery Physician Taxonomy 2086S0127X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1164965570
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karen Vaughn — Officer · (973) 251-1132
NPI enumeratedDecember 2, 2016
Last updated in NPPESOctober 16, 2023
Certification dateOctober 16, 2023
Mailing addressPo Box 99130, Las Vegas, NV 89193-9130

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