MEDICARE: DR. ERIK JON NATKIN 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
1	208D00000X	General Practice Physician	9006473-1204	UT
2	390200000X	Student in an Organized Health Care Education/Training Program	TL3403	CO

General Provider Information

NPI Number	:	1528299542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIK JON NATKIN D.O.

Provider Business Mailing Address
First Line	:	4541 SOUTH 700 EAST
Second Line	:	SUITE 100
City	:	MURRAY
State	:	UT
Zip	:	84107
Country	:	US
Telephone Number	:	801-713-1560
Fax Number	:

Provider Business Practice Location Address
First Line	:	4541 SOUTH 700 EAST
Second Line	:	SUITE 100
City	:	MURRAY
State	:	UT
Zip	:	84107
Country	:	US
Telephone Number	:	801-713-1560
Fax Number	:

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

Provider Enumeration Date	:	08/07/2009
Last Update Date	:	02/09/2015

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