Organization
MOUNTAINSTAR MEDICAL GROUP-OGDEN REGIONAL MEDICAL CENTER, LLC
Active
Other names
Mountainstar Primary Care, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS JOSEPH (VP)
(615) 373-7630
Entity
Organization
Contact information
Practice address
5405 S 500 E, STE. 100, OGDEN, UT 84405-6957
(801) 282-5952
(801) 569-5990
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 373-7406
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356588008
—
UT
Enumeration date
01/17/2009
Last updated
08/29/2023
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