Basic Information
| Provider Information | |||||||||
| NPI: | 1619084928 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LURAS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | CHRIS | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD PC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LURAS | ||||||||
| OtherFirstName: | JOHN | ||||||||
| OtherMiddleName: | C | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD PC | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 82 S 1100 E | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841021686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013504602 | ||||||||
| FaxNumber: | 8015961009 | ||||||||
| Practice Location | |||||||||
| Address1: | 82 S 1100 E | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841021686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013504602 | ||||||||
| FaxNumber: | 8015961009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 11/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 1851451205 | UT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.