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General NPI Number Information
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NPI Number | 1972795052
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Entity Type | Organization
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Legal Business Name | BENJAMIN N STORZ MD PLLC
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1868 W 9800 S 100
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-9060
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Country | US
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Telephone | 801-433-2873
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Fax | 801-433-5734
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Provider Business Mailing Address
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Address Line | 1868 W 9800 S 100
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-9060
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Country | US
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Telephone | 801-433-2873
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Fax | 801-433-5734
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Authorized Official
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Title or Position | OWNER / MD
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Name | DR. BENJAMIN N STORZ
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Credential | MD
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Telephone | 801-433-2873
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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 | 6020597-1205
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License Number State | UT
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