Provider Demographics
NPI:1538452834
Name:ST. GEORGE OBGYN LLC
Entity type:Organization
Organization Name:ST. GEORGE OBGYN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:LUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-674-0999
Mailing Address - Street 1:295 S 1470 E STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1762
Mailing Address - Country:US
Mailing Address - Phone:435-674-0999
Mailing Address - Fax:435-674-0960
Practice Address - Street 1:295 S 1470 E STE 300
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-674-0999
Practice Address - Fax:435-674-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTG67096OtherUPIN