Provider Demographics
NPI:1467220863
Name:AFFORDABLE DERMATOLOGY UTAH
Entity Type:Organization
Organization Name:AFFORDABLE DERMATOLOGY UTAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ORME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-574-8000
Mailing Address - Street 1:11743 S HARVEST BEND WAY
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-6603
Mailing Address - Country:US
Mailing Address - Phone:801-688-0050
Mailing Address - Fax:
Practice Address - Street 1:1434 E 9400 S STE 103
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-2909
Practice Address - Country:US
Practice Address - Phone:801-688-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty