Healthcare Provider Details

I. General information

NPI: 1114101235
Provider Name (Legal Business Name): WILLIAM JOSEPH PECHE, JR. M.D. P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 TENTH AVE SUITE 280
SALT LAKE CITY UT
84103-2853
US

IV. Provider business mailing address

324 TENTH AVE SUITE 280
SALT LAKE CITY UT
84103-2853
US

V. Phone/Fax

Practice location:
  • Phone: 801-408-5930
  • Fax: 801-408-5259
Mailing address:
  • Phone: 801-408-5930
  • Fax: 801-408-5259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM JOSEPH PECHE JR.
Title or Position: OWNER
Credential: MD
Phone: 801-408-5930