Organization
NORTHEASTERN UTAH MEDICAL GROUP
Active
Parent organization
UINTAH BASIN MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
UINTAH BASIN MEDICAL CENTER
Authorized official
JAMES I MARSHAL (CEO)
(435) 722-6162
Entity
Organization
Contact information
Practice address
250 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-4691
(435) 722-9291
Mailing address
250 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-4691
(435) 722-9291
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6411766-1206
UT
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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