Provider Demographics
NPI:1376795989
Name:PARK CITY GYNECOLOGY, LLC
Entity Type:Organization
Organization Name:PARK CITY GYNECOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:435-214-5335
Mailing Address - Street 1:1441 UTE BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-7630
Mailing Address - Country:US
Mailing Address - Phone:435-214-5335
Mailing Address - Fax:435-214-5340
Practice Address - Street 1:1441 UTE BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-7630
Practice Address - Country:US
Practice Address - Phone:435-214-5335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4894125-1204207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty