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NPI Code Detail

MEDICARE: DR. ROBERT ANDREW MEHL D.O.

MEDICARE: DR. ROBERT ANDREW MEHL D.O.
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
1207Q00000XFamily Medicine Physician036119791IL
2207Q00000XFamily Medicine Physician377963-1204UT

General Provider Information

NPI Number : 1376648212
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT ANDREW MEHL D.O.
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-357-7930
Fax Number : 801-357-7014
Provider Business Practice Location Address
First Line : 475 W 940 N
Second Line :
City : PROVO
State : UT
Zip : 84604-3301
Country : US
Telephone Number : 801-357-7930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 09/30/2021

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