Organization
NOEL NELLIS, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOEL NELLIS MD (PHYSICIAN & SURGEON)
(801) 479-9715
Entity
Organization
Contact information
Practice address
831 E 5875 S, SOUTH OGDEN, UT 84405-4997
(801) 479-9715
(801) 479-9452
Mailing address
831 E 5875 S, SOUTH OGDEN, UT 84405-4997
(801) 479-9715
(801) 479-9452
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
146023-1205
UT
261QU0200X
Urgent Care Clinic/Center
Primary
146023-1205
UT
305S00000X
Point of Service
146023-1205
UT
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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