Organization
NORTHERN UTAH IMAGING LLC
Active
Organization
NORTHERN UTAH IMAGING LLC
Active
Other names
MillCreek Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE HARDIN (IMAGING & ONCOLOGY MANAGED CARE)
(615) 372-5441
Entity
Organization
Contact information
Practice address
3738 S 900 E, SALT LAKE CITY, UT 84106-1913
(801) 313-1955
(801) 313-1965
Mailing address
3738 S 900 E, SALT LAKE CITY, UT 84106-1913
(801) 313-1955
(801) 313-1965
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00141132
RR MEDICARE
UT
Enumeration date
10/18/2005
Last updated
11/08/2010
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