# MOUNTAINSTAR MEDICAL GROUP-ST. MARKS HOSPITAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Mark's Millcreek Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073795258
- **Authorized official:** LOUIS JOSEPH (VP)
- **Authorized official phone:** (615) 373-7630

## Contact information

- **Practice address:** 348 E 4500 S STE 300, SALT LAKE CITY, UT 84107-8535
- **Practice address phone:** (801) 266-2777
- **Mailing address:** 2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
- **Mailing address phone:** (615) 373-7600
- **Mailing address fax:** (866) 346-1426

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/29/2007
- **Last updated:** 01/02/2023