Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 6126495-1205 | UT |
N | 111NI0900X | Internist | 6126495-1205 | UT |
N | 207R00000X | Internist | L3441 | TX |
N | 111NI0900X | Internist | L3441 | TX |
Y | 207RH0000X | Hematologist | 6126495-1205 | UT |
N | 207RH0000X | Hematologist | L3441 | TX |
N | 207RH0003X | Hematology & Oncology | L3441 | TX |
NPI | 1427008341 |
---|---|
Provider Name | Josef T Prchal |
First Address | Salt Lake City, UT 84141-3033 |
Second Address | Salt Lake City, UT 84112-5500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C73927 | (02) | |
P00409819 | RAILROAD MEDICARE (01) | UT |