Healthcare Provider Details

I. General information

NPI: 1053856476
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A. (UT)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2016
Last Update Date: 06/22/2025
Certification Date: 06/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N 1200 W
OREM UT
84057-3522
US

IV. Provider business mailing address

5080 SPECTRUM DR STE 1200W
ADDISON TX
75001-4648
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-4211
  • Fax: 214-775-4502
Mailing address:
  • Phone: 972-364-8083
  • Fax: 214-775-4502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. JOHN R ANDERSON
Title or Position: VP
Credential: DO
Phone: 972-364-8000