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

Plastics Clinic LLC

Organization Plastic Surgery Physician · NPI 1184318826

Plastics Clinic LLC is a Plastic Surgery Physician in South Jordan, Utah. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1309 W South Jordan Pkwy Ste 110
South Jordan, UT 84095-9014
Phone: (801) 839-5557
Fax: (801) 770-4455
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1184318826
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tim Prusse — Manager · (801) 386-1337
NPI enumeratedJune 6, 2023
Last updated in NPPESOctober 31, 2023
Certification dateOctober 31, 2023
Mailing address1309 W South Jordan Pkwy Ste 110, South Jordan, UT 84095-9014

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