Organization
MARK S. NAISBITT, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S. NAISBITT M.D. (PRESIDENT)
(801) 392-1401
Entity
Organization
Contact information
Practice address
4401 HARRISON BLVD, MCKAY DEE HOSPITAL, OGDEN, UT 84403-3195
(801) 589-2006
Mailing address
3460 BAKER DR, OGDEN, UT 84403-1310
(801) 392-1401
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
184191-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005532737
MEDICARE ID-TYPE UNSPECIFIED
UT
01
—
050041375
MEDICARE ID-RAILROAD MEDICARE
UT
05
—
100501270
—
NV
05
—
104856200
—
WY
01
—
107005583101
IHC
UT
01
—
1502954
UMWA
UT
01
—
20167
DESERET MUTUAL
UT
01
—
2090168
UNITED HEALTHCARE
UT
01
—
37807
PEHP
UT
01
—
53257
HEALTHY U
UT
05
—
804100900
—
ID
05
—
822107
—
AZ
01
—
8597445
WORKERS COMP
UT
01
—
87054614NA1
EDUCATORS MUTUAL
UT
01
—
PRA06691
MOLINA
UT
01
—
QM0000075886
ALTIUS
UT
Enumeration date
12/11/2012
Last updated
12/11/2012
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