PIONEER VALLEY HOSPITAL PHYSICIANS, INC (INTERNAL MEDICINE SPECIALISTS) - NPI NUMBER 1396782124

Summary

Provider Name: PIONEER VALLEY HOSPITAL PHYSICIANS, INC (INTERNAL MEDICINE SPECIALISTS)

NPI Number: 1396782124

Clasification: Internal Medicine (207R00000X)

Address:
2530 W 4700 S
SUITE B8
SALT LAKE CITY, UT
ZIP 84118

Phone Number: (801) 967-5866



Detailed Information

PIONEER VALLEY HOSPITAL PHYSICIANS, INC is an internist in Salt Lake City, UT. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. The assigned NPI number for this provider is 1396782124 and is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Internal Medicine Specialists.

The provider's business address is:

2530 W 4700 S
SUITE B8
SALT LAKE CITY, UT
ZIP 84118-865
Phone: (801) 967-5866
Fax: (801) 969-9037

The provider's authorized official is Mandi J Mckay .
The authorized official title is Ceo and has the following contact phone number (801) 967-5866.

The enumeration date for this NPI number is 6/1/2006 and was last updated on 7/8/2007.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207R00000X Internal Medicine Yes

NPI Record

No. Field Name Field Value
1 NPI 1396782124
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name PIONEER VALLEY HOSPITAL PHYSICIANS, INC
5 Provider Other Organization Name INTERNAL MEDICINE SPECIALISTS
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 2530 W 4700 S
8 Provider Second Line Business Practice Location Address SUITE B8
9 Provider Business Practice Location Address City Name SALT LAKE CITY
10 Provider Business Practice Location Address State Name UT
11 Provider Business Practice Location Address Postal Code 841181865
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 8019675866
14 Provider Business Practice Location Address Fax Number 8019699037
15 Provider Enumeration Date 6/1/2006
16 Last Update Date 7/8/2007
17 Authorized Official Last Name MCKAY
18 Authorized Official First Name MANDI
19 Authorized Official Middle Name J
20 Authorized Official Title or Position CEO
21 Authorized Official Telephone Number 8019675866
22 Healthcare Provider Taxonomy Code 1 207R00000X
23 Healthcare Provider Primary Taxonomy Switch 1 Y
24 Authorized Official Credential Text MD
25 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 11/14/2014
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