Provider Demographics
NPI:1265522874
Name:MOBLEY, STEVEN ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ROSS
Last Name:MOBLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5292 S COLLEGE DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2958
Mailing Address - Country:US
Mailing Address - Phone:801-449-9990
Mailing Address - Fax:
Practice Address - Street 1:5292 S COLLEGE DR
Practice Address - Street 2:SUITE 303
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2958
Practice Address - Country:US
Practice Address - Phone:801-449-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5133249-1205207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery