Healthcare Provider Details

I. General information

NPI: 1881789212
Provider Name (Legal Business Name): JOANNE SUMPIO HINSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/07/2023
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 S 1100 E STE 310
SALT LAKE CITY UT
84102-1500
US

IV. Provider business mailing address

24 S 1100 E STE 310
SALT LAKE CITY UT
84102-1500
US

V. Phone/Fax

Practice location:
  • Phone: 801-328-1260
  • Fax: 801-350-4361
Mailing address:
  • Phone: 801-328-1260
  • Fax: 801-350-4361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number275687-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number275687-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: