Organization
MOUNTAIN WEST EAR NOSE AND THROAT LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CURT R STOCK M.D. (GEN.)
(801) 295-5581
Entity
Organization
Contact information
Practice address
1551 RENAISSANCE TOWNE DR, SUITE 310, BOUNTIFUL, UT 84010-7667
(801) 295-5581
(801) 295-9253
Mailing address
2255 N 1700 W, SUITE 200, LAYTON, UT 84041-1140
(801) 776-2180
(801) 776-2534
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
178486-1205
UT
207Y00000X
Otolaryngology Physician
188579-1205
UT
207Y00000X
Otolaryngology Physician
Primary
264339-1205
UT
207Y00000X
Otolaryngology Physician
5387A
WY
207Y00000X
Otolaryngology Physician
5395A
WY
207YP0228X
Pediatric Otolaryngology Physician
182660-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108796700
—
WY
05
—
124257100
—
WY
01
—
DA4984
RAILROAD MEDICARE
UT
Enumeration date
01/08/2007
Last updated
08/05/2010
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