MOUNTAIN UTAH FAMILY MEDICINE; NPI #1659402774

Contact Information

MOUNTAIN UTAH FAMILY MEDICINE

879 N MAIN ST
RICHFIELD, UT 84701-1840

Phone: 435-896-9561
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for MOUNTAIN UTAH FAMILY MEDICINE

NPI Number 1659402774

LBN Legal business name MOUNTAIN UTAH FAMILY MEDICINE

Authorized official DAVID POPE - (MD)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/08/2007

Last updated 07/16/2024 - More than a year ago

Identifiers

UT	License #	463813
UT	Medicaid	528925279034

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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