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NPI Code Detail

MEDICARE: OB/GYN ASSOCIATES. L.C.

MEDICARE: OB/GYN ASSOCIATES. L.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
1174400000XSpecialist39454UT

General Provider Information

NPI Number : 1962417840
Entity Type Code : Organization
Provider Name (Legal Business Name) : OB/GYN ASSOCIATES. L.C.
Provider Business Mailing Address
First Line : 1151 E 3900 S
Second Line : SUITE B-299
City : SALT LAKE CITY
State : UT
Zip : 84124-1216
Country : US
Telephone Number : 801-268-6811
Fax Number : 801-268-8673
Provider Business Practice Location Address
First Line : 1151 E 3900 S
Second Line : SUITE B-299
City : SALT LAKE CITY
State : UT
Zip : 84124-1216
Country : US
Telephone Number : 801-268-6811
Fax Number : 801-268-8673
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : AMANDA M SCHINDLER
Credential :
Telephone Number : 801-268-6811
Provider Enumeration Date : 07/29/2006
Last Update Date : 04/01/2008

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