Park City Internal Medicine - Pediatrics, Lc in Park City - Health Service
Park City Internal Medicine - Pediatrics, Lc - NPI 1750569562
Park City Internal Medicine - Pediatrics, Lc is a Health Service in Park City, Utah. Park City Internal Medicine - Pediatrics, Lc practices all healthcare services and medical treatments related to Health Service. The NPI Number for Park City Internal Medicine - Pediatrics, Lc is 1750569562. The last update date is 2011-05-18.
Park City Internal Medicine - Pediatrics, Lc's current location address is 1612 Ute Blvd, Park City, Utah. You can contact this provider via phone number 4356553309 and fax number 4356553392. The mailing address for Park City Internal Medicine - Pediatrics, Lc is 1612 Ute Blvd, Park City, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Park City Internal Medicine - Pediatrics, Lc |
|---|---|
| Address | 1612 Ute Blvd, Park City, Utah |
| Phone Number | 4356553309 |
| Fax Number | 4356553392 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Peacock Penny |
| Credentials | MD |
| Telephone Number | 4356553309 |
NPI Number Detail
| NPI Number | 1750569562 |
|---|---|
| Provider Enumeration Date | 2008-02-04 |
| Last Updated Date | 2011-05-18 |
Provider Mailing Address Detail
| Address | 1612 Ute Blvd |
|---|---|
| City | Park City |
| State | Utah (UT) |
| Post Code | 840987500 |
| Phone Number | 4356553309 |
| Fax Number | 4356553392 |
Provider's Primary Taxonomy Detail
| Speciality | Health Service |
|---|---|
| Taxonomy | 261Qh0100X |
| Licence No | 5151398-1205 |
|
Definition: Provides general outpatient medical care by physicians and other providers. |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Park City Internal Medicine - Pediatrics, Lc by the Centers for Medicare & Medicaid Services?
The Park City Internal Medicine - Pediatrics, Lc has been issued the NPI (National Provider Identifier) 1750569562, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Park City Internal Medicine - Pediatrics, Lc is physically located?
The Park City Internal Medicine - Pediatrics, Lc is physically situated at the following address: 1612 Ute Blvd, Park City, UT, 840987500.
What is Park City Internal Medicine - Pediatrics, Lc's area of expertise and its corresponding taxonomy classification?
The Park City Internal Medicine - Pediatrics, Lc's field of specialization is Health Service, and it falls under the taxonomy code 261Qh0100X, which categorizes healthcare providers based on their areas of practice.
When was the Park City Internal Medicine - Pediatrics, Lc's 1750569562 issued?
The Park City Internal Medicine - Pediatrics, Lc's 1750569562 was issued on 2008-02-04.
As of what date were the details related to Park City Internal Medicine - Pediatrics, Lc most recently updated or revised?
The information pertaining to Park City Internal Medicine - Pediatrics, Lc, including its address, specialty, and other relevant details, was last updated or revised on 2011-05-18.
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