Bourne, Robert B
Bourne, Robert B is an individual health care provider with primary practice located at 1160 E 3900 S Ste 5000 , Salt Lake City UT 84124-1275. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Bourne, Robert B can be contacted via phone (801) 262-8486.Contact Information
Primary practice address
1160 E 3900 S Ste 5000
Salt Lake City UT 84124-1275
Phone: (801) 262-8486
Fax: (801) 261-7429
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 180189-1205 | Utah |
Profile Details
| NPI number | 1487646998 |
|---|---|
| LBN Legal business name | Bourne, Robert B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Feb 9th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487646998 | NPPES |
| Utah | MEDICAID | 09941 |
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