Provider Demographics
NPI:1205222627
Name:BRITTNEY BALOGH, MD, PC
Entity Type:Organization
Organization Name:BRITTNEY BALOGH, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CULP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-584-4422
Mailing Address - Street 1:24 S 1100 E
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1500
Mailing Address - Country:US
Mailing Address - Phone:801-478-0010
Mailing Address - Fax:801-363-1847
Practice Address - Street 1:24 S 1100 E
Practice Address - Street 2:SUITE 302
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1500
Practice Address - Country:US
Practice Address - Phone:801-478-0010
Practice Address - Fax:801-363-1847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9031999-1205208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty