Provider Demographics
NPI:1588863377
Name:VALLEY OBSTETRICS AND GYNECOLOGY, PC
Entity type:Organization
Organization Name:VALLEY OBSTETRICS AND GYNECOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAMOREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-756-9635
Mailing Address - Street 1:920 N 500 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3339
Mailing Address - Country:US
Mailing Address - Phone:801-374-1801
Mailing Address - Fax:801-375-0369
Practice Address - Street 1:120 N 1220 E
Practice Address - Street 2:SUITE 7
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2089
Practice Address - Country:US
Practice Address - Phone:801-756-9635
Practice Address - Fax:801-756-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1762301205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT00055129Medicare PIN