=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083740070
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE D ASCH MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2007
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | E8 LDS HOSPITAL 8TH AVENUE AND C STREET
-----------------------------------------------------
City | SALT LAKE CITY
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84143-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-408-3729
-----------------------------------------------------
Fax | 801-408-8453
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7381 BUCKBOARD DR
-----------------------------------------------------
City | PARK CITY
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84098-5310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 435-658-0336
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080P0207X
-----------------------------------------------------
Taxonomy Name | Pediatric Hematology & Oncology Physician
-----------------------------------------------------
License Number | 4991679-1205
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------