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NPI Code Detail

MEDICARE: IHC HEALTH SERVICES INC

MEDICARE: IHC HEALTH SERVICES INC
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
1207RG0100XGastroenterology Physician201474242UT

General Provider Information

NPI Number : 1245649060
Entity Type Code : Organization
Provider Name (Legal Business Name) : IHC HEALTH SERVICES INC
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-387-5620
Fax Number :
Provider Business Practice Location Address
First Line : 4403 HARRISON BLVD STE 3815
Second Line :
City : OGDEN
State : UT
Zip : 84403-3330
Country : US
Telephone Number : 801-387-5620
Fax Number :
Authorized Official
Title or Position : SVP - CHIEF PHY EXECUTIVE
Name : DR. MARK BRIESACHER
Credential : MD
Telephone Number : 801-442-3495
Provider Enumeration Date : 08/06/2014
Last Update Date : 01/07/2021

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Directions to “IHC HEALTH SERVICES INC ” Practice Location

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