National Provider Identifier Database

GREGORY IVERSON FAMILY MEDICINE PLLC
Rural Health


Contact Information

GREGORY IVERSON FAMILY MEDICINE PLLC
142 SOUTH 50 EAST
COALVILLE, UT84017-0865
Phone: 435-336-4403
Fax: 435-336-5570
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for GREGORY IVERSON FAMILY MEDICINE PLLC

NPI Number 1720379936
Legal business name
LBN
GREGORY IVERSON FAMILY MEDICINE PLLC
Authorized official GREGORY IVERSON - (FAMILY PHYSICIAN/MANAGING MEMBER)
Entity Organization
Organization subpart No
Enumeration date 04/21/2011
Last updated 11/30/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • UT License #: 7261660-1204

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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