Healthcare Provider Details

I. General information

NPI: 1619964053
Provider Name (Legal Business Name): JOSEPH MORELLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 ROUND VALLEY PARK CITY MEDICAL CENTER
PARK CITY UT
84060
US

IV. Provider business mailing address

3340 NORTH CENTER ST #800
LEHI UT
84043-7406
US

V. Phone/Fax

Practice location:
  • Phone: 435-658-7000
  • Fax:
Mailing address:
  • Phone: 801-990-1910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number194949
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number64541688905
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: