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General NPI Number Information
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NPI Number | 1902807993
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Entity Type | Individual
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Provider Name | JAMES DALE UTT DO
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 01/22/2014
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Provider Practice Location Address
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Address Line | 2503 FORESIGHT CIR
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1139
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Country | US
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Telephone | 970-242-2660
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Fax | 970-242-0080
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Provider Business Mailing Address
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Address Line | 2503 FORESIGHT CIR
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1139
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Country | US
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Telephone | 970-242-2660
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Fax | 970-242-0080
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 22570
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License Number State | CO
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