Provider Demographics
NPI:1598093676
Name:CHURCH OF JESUS CHRIST OF LATTER-DAY SAINTS
Entity Type:Organization
Organization Name:CHURCH OF JESUS CHRIST OF LATTER-DAY SAINTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MISSIONARY SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SWENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-240-6807
Mailing Address - Street 1:50 E NORTH TEMPLE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84150-9001
Mailing Address - Country:US
Mailing Address - Phone:801-240-7733
Mailing Address - Fax:
Practice Address - Street 1:50 E NORTH TEMPLE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84150-9001
Practice Address - Country:US
Practice Address - Phone:801-240-7733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT169094-8905208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty