Organization
UNIVERSITY OF UTAH CARDIOTHORACIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNINE RUSHTON-FOWLER (DIRECTOR OF CONTRACTING)
(801) 587-6336
Entity
Organization
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
127 S 500 E, SUITE 600, SALT LAKE CITY, UT 84102-1959
(801) 587-6336
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
08/07/2006
Last updated
04/08/2015
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