# SALT LAKE INFECTIOUS DISEASE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750523338
- **Authorized official:** JODY K MEZA (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (801) 328-1260

## Contact information

- **Practice address:** 1060 E 100 S, SUITE L10, SALT LAKE CITY, UT 84102-1501
- **Practice address phone:** (801) 328-1260
- **Mailing address:** 1060 E 100 S, SUITE L10, SALT LAKE CITY, UT 84102-1501
- **Mailing address phone:** (801) 328-1260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/30/2009
- **Last updated:** 03/30/2009