Healthcare Provider Details

I. General information

NPI: 1356459010
Provider Name (Legal Business Name): MATTHEW JAMES PARSONS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 COTTONWOOD ST
MURRAY UT
84107-5701
US

IV. Provider business mailing address

PO BOX 30180
SALT LAKE CITY UT
84130-0180
US

V. Phone/Fax

Practice location:
  • Phone: 801-269-2500
  • Fax: 801-269-2690
Mailing address:
  • Phone: 801-269-2500
  • Fax: 801-269-2690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35395
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number6522771-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: