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General NPI Number Information
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NPI Number | 1912574377
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Entity Type | Individual
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Provider Name | MARQUES SKOT NEILSON DO
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Gender | Male
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 2850 N 2000 W STE 101
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City | FARR WEST
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State | UT
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Zip | 84404-9230
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Country | US
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Telephone | 801-528-5095
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Fax | 801-528-5094
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Provider Business Mailing Address
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Address Line | 1055 N. 500 W. ATTN CREDENTIALING
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City | PROVO
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State | UT
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Zip | 84604
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Country | US
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Telephone | 801-354-8225
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Fax | 801-418-0941
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 010846
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT020864
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | R4167
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1421541-1204
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License Number State | UT
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