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MOUNTAINSTAR BRIGHAM OBGYN LLC NPI 1134379696


NPI Information

NPI: 1134379696
Provider Name: MOUNTAINSTAR BRIGHAM OBGYN, LLC

Doing Business As: BRIGHAM CENTER FOR WOMEN'S HEALTH

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 46D0957143

Address:
970 MEDICAL DR STE 202
BRIGHAM CITY, UT
ZIP 84302
Phone: (435) 695-2273
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MOUNTAINSTAR BRIGHAM OBGYN, LLC is an obstetrics gynecology in Brigham City, UT. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. MOUNTAINSTAR BRIGHAM OBGYN, LLC NPI is 1134379696. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Brigham Center For Women's Health.

The provider's business location address is:

970 MEDICAL DR STE 202
BRIGHAM CITY, UT
ZIP 84302-286
Phone: (435) 695-2273

The provider's authorized official is Louis Joseph .
The authorized official title is Vp and has the following contact phone number (615) 373-7630.

The CLIA number assigned to this NPI record is 46D0957143 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2008 and was last updated on 8/29/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11134379696MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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