Healthcare Provider Details

I. General information

NPI: 1578973921
Provider Name (Legal Business Name): JOSEPH LINCOLN ABRAMS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 08/30/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MDG HILL AFB 84056
HILL AFB UT
84056
US

IV. Provider business mailing address

75 MDG HILL AFB 84056
HILL AFB UT
84056
US

V. Phone/Fax

Practice location:
  • Phone: 801-777-1168
  • Fax:
Mailing address:
  • Phone: 801-777-1168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberOS017843
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberOS017843
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: