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NPI Code Detail

MEDICARE: DR. PETER J. HASBY M.D.

MEDICARE: DR. PETER J. HASBY 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
1207Q00000XFamily Medicine Physician186777-1205UT

General Provider Information

NPI Number : 1548247307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER J. HASBY M.D.
Provider Business Mailing Address
First Line : 228 S SANDRUN RD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84103-2227
Country : US
Telephone Number : 801-586-8858
Fax Number :
Provider Business Practice Location Address
First Line : 461 S 400 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3302
Country : US
Telephone Number : 801-539-8617
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 07/08/2007

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