Provider Demographics
NPI:1639277270
Name:HEART OF UTAH P.C.
Entity Type:Organization
Organization Name:HEART OF UTAH P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:AVARD
Authorized Official - Last Name:RIGBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-347-3400
Mailing Address - Street 1:4403 HARRISON BLVD STE 3400
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-3281
Mailing Address - Country:US
Mailing Address - Phone:801-387-3400
Mailing Address - Fax:801-387-3420
Practice Address - Street 1:4403 HARRISON BLVD STE 3400
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-3281
Practice Address - Country:US
Practice Address - Phone:801-387-3400
Practice Address - Fax:801-387-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1012013207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001Medicaid