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General NPI Number Information
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NPI Number | 1598778581
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Entity Type | Organization
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Legal Business Name | UTAH PAIN MANAGEMENT PC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 4364 WASHINGTON BLVD
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City | OGDEN
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State | UT
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Zip | 84403-1866
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Country | US
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Telephone | 801-993-9527
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Fax | 801-733-5872
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Provider Business Mailing Address
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Address Line | 1954 FORT UNION BLVD 107
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-6800
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Country | US
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Telephone | 801-993-9527
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Fax | 801-733-5872
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTIN D. BROWN
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Credential | MD
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Telephone | 801-993-9527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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