Provider Demographics
NPI:1124172697
Name:CALL, JUSTIN A (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:A
Last Name:CALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1121 E 3900 S
Mailing Address - Street 2:STE C230
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1214
Mailing Address - Country:US
Mailing Address - Phone:801-262-9494
Mailing Address - Fax:801-270-2234
Practice Address - Street 1:3592 W 9000 S
Practice Address - Street 2:STE 200
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-8812
Practice Address - Country:US
Practice Address - Phone:801-562-8732
Practice Address - Fax:801-267-5633
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2016-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301092057207RH0003X
UT836621-1205207RH0003X
UT8366221-1205207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000076555Medicare PIN
MIN56640016Medicare PIN