STAT-MD I NPI 1164063277

NPI Information

NPI: 1164063277
Provider Name: STAT-MD I
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1784 UINTA WAY UNIT E2
PARK CITY, UT
ZIP 84098
Phone: (435) 604-0160
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STAT-MD I is a primary care clinic center in Park City, UT. STAT-MD I NPI is 1164063277. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1784 UINTA WAY UNIT E2
PARK CITY, UT
ZIP 84098-685
Phone: (435) 604-0160
Fax: (435) 731-8328

The provider's authorized official is Bryan Knepper .
The authorized official title is Owner and has the following contact phone number (435) 604-0160.

The CLIA number assigned to this NPI record is 46D2121377 - other - urgent care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/1/2019 and was last updated on 10/1/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine				No
2	261QP2300X	Clinic/Center	Primary Care			Yes

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

NPI Synchronization or Removal

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