Organization
UTAH GASTROENTEROLOGY LLC
Active
Parent organization
UTAH GASTROENTEROLOGY LLC
Other names
FKA Mountain West Gastroenterology, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
UTAH GASTROENTEROLOGY LLC
Authorized official
CHRISTINE MORRIS (CORPORATE ADMINISTRATOR)
(801) 944-3191
Entity
Organization
Contact information
Practice address
620 EAST MEDICAL DRIVE, SUITE 205, BOUNTIFUL, UT 84010-5084
(801) 298-0057
(801) 298-9765
Mailing address
6360 SOUTH 3000 EAST, SUITE 220, SALT LAKE CITY, UT 84121-6923
(801) 944-3199
(801) 944-3180
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD3562
RAILROAD MEDICARE PIN
UT
Enumeration date
06/12/2006
Last updated
07/22/2021
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