Provider Demographics
NPI:1083209589
Name:HILLSIDE HEALTH PC
Entity Type:Organization
Organization Name:HILLSIDE HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:801-850-1110
Mailing Address - Street 1:2334 E 3910 S
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5022
Mailing Address - Country:US
Mailing Address - Phone:801-850-1110
Mailing Address - Fax:
Practice Address - Street 1:1841 E. RIVERSIDE DR.
Practice Address - Street 2:
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:801-850-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1225412885OtherINDIVIDUAL NPI - BROOKS BEAL, DO
1598119190OtherINDIVIDUAL NPI - COLBY BEAL, DO