Organization
MOUNTAINSTAR OGDEN PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS JOSEPH (VP)
(615) 373-7630
Entity
Organization
Contact information
Practice address
5495 S 500 E, SUITE 120, OGDEN, UT 84405-6923
(801) 479-0174
(801) 479-8888
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 373-7406
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265694509
—
UT
Enumeration date
06/27/2008
Last updated
08/29/2023
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