| Jupiter Medical I Llc | |
|
1784 Uinta Way Unit E2 Park City UT 84098-7685 | |
| (435) 604-0160 | |
| (435) 731-8328 |
| Full Name | Jupiter Medical I Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1784 Uinta Way Unit E2, Park City, Utah |
| Authorized Official Name and Position | Bryan Knepper (OWNER) |
| Authorized Official Contact | 6175713680 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jupiter Medical I Llc 21 White Hill Rd Cold Spring Harbor NY 11724-1211 Ph: () - | Jupiter Medical I Llc 1784 Uinta Way Unit E2 Park City UT 84098-7685 Ph: (435) 604-0160 |
| NPI Number | 1104346543 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 06/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104346543 | NPI | - | NPPES |
| U000092310 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Utah) | Primary |
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