Provider Demographics
NPI:1619084928
Name:LURAS, JOHN CHRIS (MD PC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRIS
Last Name:LURAS
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:C
Other - Last Name:LURAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PC
Mailing Address - Street 1:82 S 1100 E
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1686
Mailing Address - Country:US
Mailing Address - Phone:801-350-4602
Mailing Address - Fax:801-596-1009
Practice Address - Street 1:82 S 1100 E
Practice Address - Street 2:SUITE 204
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1686
Practice Address - Country:US
Practice Address - Phone:801-350-4602
Practice Address - Fax:801-596-1009
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1851451205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000060859Medicare PIN
F09411Medicare UPIN