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NPI Code Detail

MEDICARE: MOUNTAIN STATES PSYCHIATRIC PARTNERS PLLC

MEDICARE: MOUNTAIN STATES PSYCHIATRIC PARTNERS PLLC
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1497694111
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNTAIN STATES PSYCHIATRIC PARTNERS PLLC
Provider Business Mailing Address
First Line : 6008 S 2125 E
Second Line :
City : OGDEN
State : UT
Zip : 84403-5352
Country : US
Telephone Number : 541-591-4848
Fax Number :
Provider Business Practice Location Address
First Line : 5475 ADAMS AVE PKWY
Second Line :
City : OGDEN
State : UT
Zip : 84405-6905
Country : US
Telephone Number : 801-479-2111
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : DR. AUSTIN GOEBEL
Credential : DO
Telephone Number : 541-591-4848
Provider Enumeration Date : 03/27/2026
Last Update Date : 04/06/2026

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Directions to “MOUNTAIN STATES PSYCHIATRIC PARTNERS PLLC ” Practice Location

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