Provider Demographics
NPI:1679953756
Name:NOETIC PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:NOETIC PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DRASCHIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-369-8989
Mailing Address - Street 1:672 W 400 S
Mailing Address - Street 2:STE 201
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-3157
Mailing Address - Country:US
Mailing Address - Phone:801-369-8989
Mailing Address - Fax:
Practice Address - Street 1:672 W 400 S
Practice Address - Street 2:STE 201
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-3157
Practice Address - Country:US
Practice Address - Phone:801-369-8989
Practice Address - Fax:801-704-9741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT31913112052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty