Provider Demographics
NPI:1093715542
Name:EGGERT, JOAN (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:EGGERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:515 S 300 E
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3900
Mailing Address - Country:US
Mailing Address - Phone:435-628-0498
Mailing Address - Fax:435-628-1897
Practice Address - Street 1:515 S 300 E
Practice Address - Street 2:SUITE 206
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3900
Practice Address - Country:US
Practice Address - Phone:435-669-2148
Practice Address - Fax:435-688-5524
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2012-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT177782-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD07740Medicare UPIN