Provider Demographics
NPI:1427273705
Name:UTAH HEMATOLOGY ONCOLOGY PC
Entity type:Organization
Organization Name:UTAH HEMATOLOGY ONCOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-476-1777
Mailing Address - Street 1:4403 HARRISON BLVD STE 1685
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-3274
Mailing Address - Country:US
Mailing Address - Phone:801-387-7150
Mailing Address - Fax:801-387-7155
Practice Address - Street 1:4403 HARRISON BLVD STE 1685
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-3274
Practice Address - Country:US
Practice Address - Phone:801-387-7150
Practice Address - Fax:801-387-7155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty