MEDICARE: JOSEF T PRCHAL M.D.

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	207R00000X	Internal Medicine Physician	L3441	TX
2	207R00000X	Internal Medicine Physician	6126495-1205	UT
3	207RH0000X	Hematology (Internal Medicine) Physician	L3441	TX
4	207RH0003X	Hematology & Oncology Physician	L3441	TX
5	207RH0000X	Hematology (Internal Medicine) Physician	6126495-1205	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00409819	OTHER	UT	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1427008341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEF T PRCHAL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 413033
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84141-3033
Country	:	US
Telephone Number	:	801-213-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1950 CIRCLE OF HOPE DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84112-5500
Country	:	US
Telephone Number	:	801-585-0100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	12/27/2021

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Directions to “ JOSEF T PRCHAL M.D.” Practice Location

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