Healthcare Provider Details

I. General information

NPI: 1043520489
Provider Name (Legal Business Name): STEPHANIE CHAMBERS THOMAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N HOSPITAL DR
PRICE UT
84501-4218
US

IV. Provider business mailing address

HC 35 BOX 82
KENILWORTH UT
84529-9511
US

V. Phone/Fax

Practice location:
  • Phone: 435-637-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number13789
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM-11702
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: