Individual provider · NPI-1

Dr. Mark Vernon Anderson, MD

Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine · Salt Lake City, UT

NPI number1245455096
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1245455096
Entity type
Individual (NPI-1)
Name
Dr. Mark Vernon Anderson
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 16, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine1660581205UTYes

Practice location

2390 S Redwood Rd
Salt Lake City, UT 84119-2027

Phone 801-975-1600 · Fax 801-975-1666

Mailing address

4018 Prospector Dr
Salt Lake City, UT 84121-4609

Phone 801-975-1600 · Fax 801-975-1666

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