Provider Demographics
NPI:1235526088
Name:LONE PEAK MEDICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:LONE PEAK MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-558-5126
Mailing Address - Street 1:14768 S DRYBURG CV
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5673
Mailing Address - Country:US
Mailing Address - Phone:801-558-5126
Mailing Address - Fax:801-206-3823
Practice Address - Street 1:14768 S DRYBURG CV
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5673
Practice Address - Country:US
Practice Address - Phone:801-558-5126
Practice Address - Fax:801-206-3823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty