Basic Information
| Provider Information | |||||||||
| NPI: | 1346248465 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVEY | ||||||||
| FirstName: | JUSTIN | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 581289 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841581289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015856943 | ||||||||
| FaxNumber: | 8015813899 | ||||||||
| Practice Location | |||||||||
| Address1: | 295 S CHIPETA WAY | ||||||||
| Address2: | UNIVERSITY OF UTAH DEPARTMENT OF PEDIATRICS | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841081287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015856943 | ||||||||
| FaxNumber: | 8015813899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2005 | ||||||||
| LastUpdateDate: | 10/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 325484-1205 | UT | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.