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NPI Code Detail

MEDICARE: GEORGES DESJARDINS MD

MEDICARE: GEORGES DESJARDINS MD
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
1207L00000XAnesthesiology PhysicianME67839FL

General Provider Information

NPI Number : 1184677528
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGES DESJARDINS MD
Provider Business Mailing Address
First Line : PO BOX 581053
Second Line :
City : SLC
State : UT
Zip : 84158-1053
Country : US
Telephone Number : 801-213-3800
Fax Number :
Provider Business Practice Location Address
First Line : 50 N MEDICAL DR
Second Line :
City : SLC
State : UT
Zip : 84132-0001
Country : US
Telephone Number : 801-581-6393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 12/11/2013

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Directions to “ GEORGES DESJARDINS MD” Practice Location

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