MEDICARE: UTAH ARTHRITIS CLINIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	184871-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134273485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UTAH ARTHRITIS CLINIC PC

Provider Business Mailing Address
First Line	:	154 MYRTLE AVE
Second Line	:	SUITE 204
City	:	MURRAY
State	:	UT
Zip	:	84107-4833
Country	:	US
Telephone Number	:	801-266-9300
Fax Number	:	801-266-9305

Provider Business Practice Location Address
First Line	:	154 MYRTLE AVE
Second Line	:	SUITE 204
City	:	MURRAY
State	:	UT
Zip	:	84107-4833
Country	:	US
Telephone Number	:	801-266-9300
Fax Number	:	801-266-9305

Authorized Official
Title or Position	:	OWNER
Name	:	DON L STROMQUIST
Credential	:	M.D.
Telephone Number	:	801-266-9300

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	01/26/2009

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