Individual provider · Type 1 NPI

Maxi Edra Dax, PA

Medical Physician Assistant · Panguitch, UT

NPI number 1538617014 Active

Practice location

200 North 400 East
Panguitch, UT 84759

Call (435) 690-1246 Map

Mailing address

95 North 100 East, P.o.box 738
Panguitch, UT 84759

Specialties and licenses

Taxonomy	Code	License
Medical Physician Assistant Primary	363AM0700X	10079306-1206 (UT)

Medical Physician Assistant: Definition to come...

Another provider at this address

Timothy B. Smith, RPHPharmacist Panguitch, UT NPI 1538271010

About NPI 1538617014

Maxi Edra Dax, PA's National Provider Identifier is 1538617014, issued on Sep 14, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Panguitch, UT. The record was last updated on Jan 25, 2024.