Rallison, Mark W

Rallison, Mark W is an individual health care provider with primary practice located at 1200 E 3900 S , Salt Lake City UT 84124-1300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Rallison, Mark W can be contacted via phone (801) 268-7288.

Contact Information

Primary practice address
1200 E 3900 S Salt Lake City UT 84124-1300
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 180903-1205 Utah

Profile Details

NPI number 1396743282
LBN Legal business name Rallison, Mark W
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Aug 28th, 2007 - about 17 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 1396743282 NPPES
Utah MEDICAID 09750

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