| Lds Campus Gi | |
|
374 10th Ave Suite 100 Salt Lake City UT 84103-2823 | |
| (801) 408-5883 | |
| Not Available |
| Full Name | Lds Campus Gi |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 374 10th Ave, Salt Lake City, Utah |
| Authorized Official Name and Position | Linda C Leckman (CEO INTERMOUNTAIN MEDICAL GROUP) |
| Authorized Official Contact | 8014423974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lds Campus Gi Po Box 27128 Salt Lake City UT 84127-0128 Ph: (801) 408-5883 | Lds Campus Gi 374 10th Ave Suite 100 Salt Lake City UT 84103-2823 Ph: (801) 408-5883 |
| NPI Number | 1568592590 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 07/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568592590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 20040514 (Utah) | Primary |
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