SRS PROGRAM – Psychiatry Physician, NPI 1205892080
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SRS PROGRAM
900 East, 9th & 9th, Salt Lake City, Salt Lake County, Utah, 84102-3541, United States
SUITE 420
SALT LAKE CITY, UT 841211720
Phone: (801) 263-7100
Fax: (801) 263-7123
Type: Mailing
2472, 300 East, South Salt Lake, Salt Lake County, Utah, 84115, United States
SALT LAKE CITY, UT 841152895
Phone: (801) 415-7591
Fax: (801) 415-7533
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84121)
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