Healthcare Provider Details

I. General information

NPI: 1548378763
Provider Name (Legal Business Name): STEPHEN J. MEIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6822 E 1000 S
FT. DUCHESNE UT
84026
US

IV. Provider business mailing address

2174 W 800 S
VERNAL UT
84078-4027
US

V. Phone/Fax

Practice location:
  • Phone: 435-722-5122
  • Fax:
Mailing address:
  • Phone: 435-725-6874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number185304-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: