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
Fax: (801) 261-7429
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487646998 NPPES
Utah MEDICAID 09941

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