Organization
OBSTETRICS AND GYNECOLOGY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CAMERON (OFFICE MANAGER)
(801) 531-6109
Entity
Organization
Contact information
Practice address
850 E 300 S, SUITE 1, SALT LAKE CITY, UT 84102-2332
(801) 322-1214
Mailing address
850 E 300 S, SUITE 1, SALT LAKE CITY, UT 84102-2332
(801) 322-1214
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05350
—
UT
01
—
46D0704114
CLIA
UT
Enumeration date
10/11/2006
Last updated
07/21/2022
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