Provider Demographics
NPI:1578985438
Name:EMERE UTAH LLC
Entity Type:Organization
Organization Name:EMERE UTAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-617-2100
Mailing Address - Street 1:801 N 500 W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6829
Mailing Address - Country:US
Mailing Address - Phone:801-617-2100
Mailing Address - Fax:801-208-7050
Practice Address - Street 1:1490 E FOREMASTER DR
Practice Address - Street 2:SUITE 260
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4488
Practice Address - Country:US
Practice Address - Phone:435-757-0072
Practice Address - Fax:435-688-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty