Provider Demographics
NPI:1871098491
Name:JOSEPH J. ALBANO, MD, PLLC
Entity type:Organization
Organization Name:JOSEPH J. ALBANO, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALBANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-971-0253
Mailing Address - Street 1:PO BOX 71547
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84171-0547
Mailing Address - Country:US
Mailing Address - Phone:385-220-9009
Mailing Address - Fax:801-869-1987
Practice Address - Street 1:6360 S 3000 E STE 210
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-6972
Practice Address - Country:US
Practice Address - Phone:385-220-9009
Practice Address - Fax:801-869-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty