| Organization Name: | CITY CREEK MEDICAL SPECIALISTS, INC |
| NPI Number: | 1134393499 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANN JEFFERDS (PRESIDENT) |
| Mailing Address: | 324 Tenth Ave Suite 160 Salt Lake City |
| State: | UT US |
| Postal Code: | 841032853 |
| Phone Number: | 8014085151 |
| Fax Number: | 8014083598 |
| NPI Enumeration Date: | 04/17/2008 |
| NPI Last Update Date: | 08/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 56382771205 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |