Provider Demographics
NPI:1548443716
Name:ZOLLINGER, LAUREN VIRGINIA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:VIRGINIA
Last Name:ZOLLINGER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25488
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0488
Mailing Address - Country:US
Mailing Address - Phone:800-475-3698
Mailing Address - Fax:719-591-2745
Practice Address - Street 1:1433 N 1075 W STE 104
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2746
Practice Address - Country:US
Practice Address - Phone:801-298-1300
Practice Address - Fax:801-296-6199
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6020095-12052085N0700X, 2085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1088740OtherDMBA
UT9934921OtherAETNA HEALTHCARE
UT1548443716OtherEMI HEALTH
UT1548443716OtherMOLINA HEALTHCARE
UT10000010000001OtherBCBSU
UT145449OtherPEHP
UT1548443716Medicaid
UT107083502104OtherSELECTHEALTH
UTP01180706OtherRAILROAD MEDICARE
UT1548443716Medicaid