| Png Utah | |
|
159 W Broadway Salt Lake City UT 84101-1907 | |
| (865) 307-3441 | |
| (865) 409-2526 |
| Full Name | Png Utah |
|---|---|
| Speciality | Internal Medicine |
| Location | 159 W Broadway, Salt Lake City, Utah |
| Authorized Official Name and Position | Theo S Stephens (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 4232719911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Png Utah 8930 Cross Park Dr Ste 3 Knoxville TN 37923-4713 Ph: (423) 271-9911 | Png Utah 159 W Broadway Salt Lake City UT 84101-1907 Ph: (865) 307-3441 |
| NPI Number | 1902311558 |
|---|---|
| Provider Enumeration Date | 12/05/2017 |
| Last Update Date | 10/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902311558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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