Organization
MARK MILES PASSEY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MILES PASSEY M.D. (PRESIDENT)
(801) 314-2308
Entity
Organization
Contact information
Practice address
5872 S 900 E, 250, SALT LAKE CITY, UT 84121-1676
(801) 314-2308
Mailing address
48 W BROADWAY APT 2001, SALT LAKE CITY, UT 84101-2015
(801) 314-2308
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
81-167082-1205
UT
Other
Enumeration date
01/29/2014
Last updated
01/29/2014
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