Basic Information
| Provider Information | |||||||||
| NPI: | 1760679443 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATES OF PATHOLOGY, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6112 S 1550 E STE 3 | ||||||||
| Address2: | |||||||||
| City: | SOUTH OGDEN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 844055018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4357340101 | ||||||||
| FaxNumber: | 8013174872 | ||||||||
| Practice Location | |||||||||
| Address1: | 5475 S 500 E | ||||||||
| Address2: | |||||||||
| City: | OGDEN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 844056905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4357340101 | ||||||||
| FaxNumber: | 8013174872 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2007 | ||||||||
| LastUpdateDate: | 03/29/2018 | ||||||||
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| AuthorizedOfficialLastName: | BERRETT | ||||||||
| AuthorizedOfficialFirstName: | KRISTINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4357340101 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0105X | 46D0660903 | UT | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine | 207ZP0102X | 46D0660903 | UT | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.