Organization
MOUNTAINSTAR MEDICAL GROUP NEUROSURGERY - ST MARKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS JOSEPH (VP)
(615) 373-7630
Entity
Organization
Contact information
Practice address
1220 E 3900 S, STE. 4-E, SALT LAKE CITY, UT 84124-1377
(801) 261-8507
(801) 261-8507
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 373-7406
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
06/24/2011
Last updated
08/29/2023
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