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General NPI Number Information
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NPI Number | 1154755882
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Entity Type | Organization
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Legal Business Name | SENIOR MOBILE DOCS
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 9980 S 300 W SUITE 245
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City | SANDY
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State | UT
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Zip | 84070-3627
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Country | US
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Telephone | 801-285-7650
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Fax |
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Provider Business Mailing Address
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Address Line | 9980 S 300 W SUITE 245
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City | SANDY
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State | UT
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Zip | 84070-3627
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Country | US
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Telephone | 801-285-7650
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. KEITH TAUFER
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Credential |
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Telephone | 801-285-7650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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