Organization
DESERT VISTA INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT SAMUEL WALLIN MD (PRESIDENT)
(602) 672-2628
Entity
Organization
Contact information
Practice address
368 E RIVERSIDE DR, 3B, SAINT GEORGE, UT 84790-6896
(435) 656-3324
(435) 656-3325
Mailing address
368 E RIVERSIDE DR, 3B, SAINT GEORGE, UT 84790-6896
(435) 656-3324
(435) 656-3325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7984164-1205
UT
Other
Enumeration date
08/06/2012
Last updated
08/06/2012
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