MEDICARE: JOHN B ENGLISH 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	207L00000X	Anesthesiology Physician	160426-1205	UT

General Provider Information

NPI Number	:	1740526169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN B ENGLISH M.D.

Provider Business Mailing Address
First Line	:	3621 E MILLCREEK CANYON RD
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-3852
Country	:	US
Telephone Number	:	801-597-2494
Fax Number	:

Provider Business Practice Location Address
First Line	:	3621 E MILLCREEK CANYON RD
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-3852
Country	:	US
Telephone Number	:	801-597-2494
Fax Number	:

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

Provider Enumeration Date	:	12/13/2012
Last Update Date	:	12/13/2012

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