Healthcare Provider Details

I. General information

NPI: 1932666781
Provider Name (Legal Business Name): HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 S MEDICAL CENTER DR
ST GEORGE UT
84790-7049
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 435-251-3793
  • Fax:
Mailing address:
  • Phone: 435-251-3793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK BRIESACHER
Title or Position: SVP-CHIEF PHYS EXEC/PRES-IM GROUP
Credential: MD
Phone: 801-442-3495