Healthcare Provider Details

I. General information

NPI: 1255527909
Provider Name (Legal Business Name): UTAH DIGESTIVE HEALTH INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 09/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6028 S RIDGELINE DR SUITE 201
OGDEN UT
84405-6914
US

IV. Provider business mailing address

1660 W ANTELOPE DR SUITE 320
LAYTON UT
84041-1156
US

V. Phone/Fax

Practice location:
  • Phone: 801-475-5400
  • Fax: 801-475-8614
Mailing address:
  • Phone: 801-773-2268
  • Fax: 801-773-2937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN E LOWE
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 801-475-5400