MEDICARE: MR. JOSEPH BEN MARKLAND PA-C

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	363A00000X	Physician Assistant	100312-1206	UT

General Provider Information

NPI Number	:	1952553950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH BEN MARKLAND PA-C

Provider Business Mailing Address
First Line	:	2599 W 2625 N
Second Line	:
City	:	FARR WEST
State	:	UT
Zip	:	84404-8707
Country	:	US
Telephone Number	:	801-731-2368
Fax Number	:

Provider Business Practice Location Address
First Line	:	2599 W 2625 N
Second Line	:
City	:	FARR WEST
State	:	UT
Zip	:	84404-8707
Country	:	US
Telephone Number	:	801-731-2368
Fax Number	:

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

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/21/2008

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