Individual
JUSTIN F THULIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1151 E 3900 S, PARKVIEW BUILDING B 259, SALT LAKE CITY, UT 84124-1216
(801) 266-7325
(801) 281-2263
Mailing address
1151 E 3900 S, STE B259, SALT LAKE CTY, UT 84124-1259
(801) 266-7325
(801) 281-2263
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
3259971205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9311824424
TAX ID NUMBER
UT
Enumeration date
06/05/2006
Last updated
10/26/2007
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