Northeastern Utah Medical Group

NPI #1316316482 in Roosevelt, Utah

Provider Information

NPI Number: 1316316482
Entity Type: Organization
Organization Name: Northeastern Utah Medical Group
Subpart: Yes (part of a larger organization)
Parent Organization: UINTAH BASIN MEDICAL CENTER
Primary Specialty: Physician Assistant
Enumeration Date: Sep 18, 2015
Last Updated: Sep 18, 2015

Practice Location

Address: 250 W 300 N
City: Roosevelt
State: Utah
ZIP Code: 84066-2336
Phone: (435) 722-4691

Authorized Official

Name: JAMES I MARSHAL
Title: CEO
Phone: (435) 722-6162

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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