Organization
UNIVERSITY OF UTAH HOSPITALS AND CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN A TERRY MD (MEDICAL DIRECTOR)
(801) 587-6307
Entity
Organization
Contact information
Practice address
1525 W 2100 S, SALT LAKE CITY, UT 84119-1401
(801) 213-9900
Mailing address
PO BOX 510708, SALT LAKE CITY, UT 84151-0708
(801) 587-6303
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
163W00000X
Registered Nurse
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213E00000X
Podiatrist
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100503428
—
NV
05
—
100503428
—
WY
05
—
807076400
—
ID
05
—
807159300
—
ID
01
—
CI9541
RAILROAD MEDICARE
UT
01
—
CN7381
RAILROAD MEDICARE
UT
01
—
CN8305
RAILROAD MEDICARE
UT
Enumeration date
06/02/2006
Last updated
09/07/2011
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