Basic Information
| Provider Information | |||||||||
| NPI: | 1558441485 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANATOMIC PATHOLOGY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 727 | ||||||||
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| City: | BRIGHAM CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 843020727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4357340101 | ||||||||
| FaxNumber: | 4357340103 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 E 3900 S | ||||||||
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| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841241300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012687177 | ||||||||
| FaxNumber: | 8012703352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ABBOTT | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | HEAD PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 4357340101 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.