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CENTRAL UTAH CLINIC P.C. NPI 1851631139


NPI Information

NPI: 1851631139
Provider Name: CENTRAL UTAH CLINIC, P.C.

Doing Business As: REVERE HEALTH

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 46D2289001

Address:
2019 E RIVERSIDE DR
SUITE A200
ST GEORGE, UT
ZIP 84790
Phone: (435) 628-9298
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CENTRAL UTAH CLINIC, P.C. is a hematology and oncology internal medicine in St George, UT. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. CENTRAL UTAH CLINIC, P.C. NPI is 1851631139. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Revere Health.

The provider's business location address is:

2019 E RIVERSIDE DR
SUITE A200
ST GEORGE, UT
ZIP 84790-134
Phone: (435) 628-9298
Fax: (435) 628-9655

The provider's authorized official is Jed Harston .
The authorized official title is Director Of Managed Care and has the following contact phone number (801) 812-5012.

The CLIA number assigned to this NPI record is 46D2289001 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/22/2013 and was last updated on 3/7/2018.


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
1207RH0003XInternal MedicineHematology & OncologyYes

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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