| Stat-md I | |
|
1784 Uinta Way Unit E2 Park City UT 84098-7685 | |
| (435) 604-0160 | |
| (435) 731-8328 |
| Full Name | Stat-md I |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1784 Uinta Way Unit E2, Park City, Utah |
| Authorized Official Name and Position | Bryan Knepper (OWNER) |
| Authorized Official Contact | 4356040160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stat-md I Po Box 981630 Park City UT 84098-1630 Ph: (435) 604-0160 | Stat-md I 1784 Uinta Way Unit E2 Park City UT 84098-7685 Ph: (435) 604-0160 |
| NPI Number | 1164063277 |
|---|---|
| Provider Enumeration Date | 10/01/2019 |
| Last Update Date | 10/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164063277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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