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NPI Code Detail

MEDICARE: IVAN D FLINT MD PC

MEDICARE: IVAN D FLINT MD PC
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
1261Q00000XClinic/Center3200011205UT

General Provider Information

NPI Number : 1821271529
Entity Type Code : Organization
Provider Name (Legal Business Name) : IVAN D FLINT MD PC
Provider Business Mailing Address
First Line : 1250 E 3900 S STE 450
Second Line :
City : SLC
State : UT
Zip : 84124-1349
Country : US
Telephone Number : 801-262-3600
Fax Number : 801-206-2555
Provider Business Practice Location Address
First Line : 1250 E 3900 S STE 450
Second Line :
City : SLC
State : UT
Zip : 84124-1349
Country : US
Telephone Number : 801-262-3600
Fax Number : 801-206-2555
Authorized Official
Title or Position : MD/ PRESIDENT
Name : IVAN D FLINT
Credential : MD
Telephone Number : 801-262-3600
Provider Enumeration Date : 12/17/2007
Last Update Date : 12/17/2007

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Directions to “IVAN D FLINT MD PC ” Practice Location

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