Healthcare Provider Details

I. General information

NPI: 1023711348
Provider Name (Legal Business Name): CHRISTOPHER R. SWEENEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 S 1100 E
SALT LAKE CITY UT
84105-2421
US

IV. Provider business mailing address

1336 S 1100 E
SALT LAKE CITY UT
84105-2421
US

V. Phone/Fax

Practice location:
  • Phone: 385-246-2522
  • Fax: 801-810-1343
Mailing address:
  • Phone: 385-246-2522
  • Fax: 801-810-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14167871-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: