Healthcare Provider Details

I. General information

NPI: 1831042621
Provider Name (Legal Business Name): CORINNE N DIX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 S 900 E STE 100
MURRAY UT
84117-5789
US

IV. Provider business mailing address

82 E PORTICO LN
SARATOGA SPRINGS UT
84045-4080
US

V. Phone/Fax

Practice location:
  • Phone: 801-449-0370
  • Fax:
Mailing address:
  • Phone: 801-616-8223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number10232788-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: