Provider Demographics
NPI:1659111243
Name:UTAH THYROID CENTER PLLC
Entity type:Organization
Organization Name:UTAH THYROID CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KONSTANTINOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGKOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:774-261-3957
Mailing Address - Street 1:2135 W MAIN ST STE B107
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6936
Mailing Address - Country:US
Mailing Address - Phone:801-655-6415
Mailing Address - Fax:
Practice Address - Street 1:2135 W MAIN ST STE B107
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6936
Practice Address - Country:US
Practice Address - Phone:801-655-6415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty