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Organization
UTAH PHS LLC
Active
Organization
UTAH PHS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SMITH (CEO)
(901) 261-4843
Entity
Organization
Contact information
Practice address
321 N MALL DR BLDG R, RED CLIFFS PROFESSIONAL PARK, SAINT GEORGE, UT 84790-7302
(877) 260-4747
Mailing address
9155 CRESTWYN HILLS DR, MEMPHIS, TN 38125-8501
(901) 261-4848
(901) 261-4849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/16/2010
Last updated
10/25/2012
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