Healthcare Provider Details

I. General information

NPI: 1871098491
Provider Name (Legal Business Name): JOSEPH J. ALBANO, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6360 S 3000 E STE 210
SALT LAKE CITY UT
84121-6972
US

IV. Provider business mailing address

PO BOX 71547
SALT LAKE CITY UT
84171-0547
US

V. Phone/Fax

Practice location:
  • Phone: 385-220-9009
  • Fax: 801-869-1987
Mailing address:
  • Phone: 385-220-9009
  • Fax: 801-869-1987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH J ALBANO
Title or Position: MD/OWNER
Credential: MD
Phone: 801-971-0253