| NPI | 1982664199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLI MORRIS Physician Credentialing 435-725-7448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207W00000X Ophthalmology | |
| 207X00000X Orthopaedic Surgery | |
| 207Y00000X Otolaryngology | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine | |
| 208000000X Pediatrics | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208600000X Surgery | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2019-05-14 |