Organization
EMERGENCY PHYSICIANS INTEGRATED CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG STOUT (CEO)
(801) 463-7415
Entity
Organization
Contact information
Practice address
1050 E SOUTH TEMPLE, SALT LAKE CITY, UT 84102-1507
(801) 350-4111
Mailing address
333 NORTH 300 WEST, SALT LAKE CITY, UT 84103-1215
(801) 463-7415
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578598199
—
UT
01
—
GC6996
RAILROAD
UT
Enumeration date
07/12/2006
Last updated
12/03/2024
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