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General NPI Number Information
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NPI Number | 1609852243
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Entity Type | Individual
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Provider Name | ROBERT M SORENSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1544 W ANTELOPE DR
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City | LAYTON
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State | UT
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Zip | 84041-1146
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Country | US
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Telephone | 801-773-3339
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Fax | 801-773-6727
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Provider Business Mailing Address
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Address Line | 54 W 1750 N
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City | CENTERVILLE
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State | UT
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Zip | 84014-1183
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Country | US
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Telephone | 801-292-1452
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 182691-1205
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License Number State | UT
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