Provider Demographics
NPI:1316972508
Name:HYPERBARIC MEDICINE PHYSICIANS LLC
Entity type:Organization
Organization Name:HYPERBARIC MEDICINE PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEJOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-582-4268
Mailing Address - Street 1:540 ARAPEEN DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1258
Mailing Address - Country:US
Mailing Address - Phone:801-582-4268
Mailing Address - Fax:801-582-4269
Practice Address - Street 1:540 ARAPEEN DR STE 110
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1258
Practice Address - Country:US
Practice Address - Phone:801-582-4268
Practice Address - Fax:801-582-4269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty