Organization
ST. MARK'S GYNECOLOGY ONCOLOGY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS JOSEPH (VP)
(615) 373-7630
Entity
Organization
Contact information
Practice address
1140 E 3900 S STE 400, SALT LAKE CITY, UT 84124-1269
(801) 268-6811
(801) 743-4736
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 373-7406
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053593921
—
UT
05
—
1053593921
—
WY
05
—
807953700
—
ID
Enumeration date
12/03/2007
Last updated
08/29/2023
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