Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 358231-1205 | UT |
NPI | 1396790309 |
---|---|
Provider Name | Chad C Lunt |
First Address | Saint George, UT 84770-3979 |
Second Address | St George, UT 84770-3979 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 29/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G67096 | (02) | UT |