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NPI Code Detail

MEDICARE: UTAH HEMATOLOGY ONCOLOGY PC

MEDICARE: UTAH HEMATOLOGY ONCOLOGY 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
1207RH0003XHematology & Oncology Physician

General Provider Information

NPI Number : 1316354780
Entity Type Code : Organization
Provider Name (Legal Business Name) : UTAH HEMATOLOGY ONCOLOGY PC
Provider Business Mailing Address
First Line : 5290 S 400 E
Second Line :
City : OGDEN
State : UT
Zip : 84405-7194
Country : US
Telephone Number : 801-476-1777
Fax Number : 801-479-1479
Provider Business Practice Location Address
First Line : 5290 S 400 E
Second Line :
City : OGDEN
State : UT
Zip : 84405-7194
Country : US
Telephone Number : 801-476-1777
Fax Number : 801-479-1479
Authorized Official
Title or Position : CEO
Name : KEVIN PORTER
Credential :
Telephone Number : 801-476-1777
Provider Enumeration Date : 07/17/2014
Last Update Date : 02/13/2024

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