Healthcare Provider Details

I. General information

NPI: 1801344189
Provider Name (Legal Business Name): WASATCH CARDIOVASCULAR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N TRIUMPH BLVD STE 330
LEHI UT
84043-4999
US

IV. Provider business mailing address

PO BOX 94670
OKLAHOMA CITY OK
73143-4670
US

V. Phone/Fax

Practice location:
  • Phone: 801-753-4711
  • Fax: 801-998-3293
Mailing address:
  • Phone: 405-682-3303
  • Fax: 405-384-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT H. PARKER JR.
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 801-463-7415