Healthcare Provider Details

I. General information

NPI: 1962821223
Provider Name (Legal Business Name): UTAH REGIONAL HOSPITALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 S 900 E STE 240
MURRAY UT
84117-7210
US

IV. Provider business mailing address

4535 DRESSLER RD NW
CANTON OH
44718-2545
US

V. Phone/Fax

Practice location:
  • Phone: 844-474-4019
  • Fax:
Mailing address:
  • Phone: 844-474-4019
  • Fax: 330-492-8489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number8871437-1205
License Number StateUT

VIII. Authorized Official

Name: JENNIFER CHRASTAIN
Title or Position: ENROLLMENT OFFICER
Credential:
Phone: 855-687-0618