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

Wasatch Surgical LLC

Organization Surgery Physician · NPI 1053201525

Wasatch Surgical LLC is a Surgery Physician in Bountiful, Utah. Works from 2 locations. Registered with an NPI since 2025.

In the registry since
2025
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

520 Medical Dr Ste 300
Bountiful, UT 84010-8925
Phone: (228) 273-9021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 74 Kimballs Lane, Draper, UT 84020 — (228) 273-9021

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X

Record details

NPI number1053201525
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mackenzie Goodwin — Owner · (228) 273-9021
Other names Mackenzie Goodwin Md
NPI enumeratedJuly 7, 2025
Last updated in NPPESJuly 7, 2025
Certification dateJuly 7, 2025
Mailing address1893 E Millbrook Rd, Salt Lake City, UT 84106-3827

Other providers in Bountiful