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General NPI Number Information
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NPI Number | 1710192042
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OBSTETRICS AND GYNECOLOGY
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 1355 N UNIVERSITY AVE SUITE 110
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City | PROVO
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State | UT
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Zip | 84604-2721
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Country | US
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Telephone | 801-374-5000
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Fax | 801-374-0077
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Provider Business Mailing Address
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Address Line | 1355 N UNIVERSITY AVE SUITE 110
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City | PROVO
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State | UT
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Zip | 84604-2721
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Country | US
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Telephone | 801-374-5000
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Fax | 801-374-0077
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | MRS. JULIE J GATELY
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Credential |
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Telephone | 801-374-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 87-0560471
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License Number State | UT
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