Provider Demographics
NPI:1558514786
Name:UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERN/INTERNAL MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:BELL
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:8017-075-5330
Mailing Address - Street 1:1136 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-4103
Mailing Address - Country:US
Mailing Address - Phone:801-707-5530
Mailing Address - Fax:
Practice Address - Street 1:30 N 1900 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0002
Practice Address - Country:US
Practice Address - Phone:801-707-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital