| Canyons Village Medical Clinic | |
|
3850 Canyons Resort Dr Park City UT 84098-6546 | |
| (435) 615-2235 | |
| Not Available |
| Full Name | Canyons Village Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 3850 Canyons Resort Dr, Park City, Utah |
| Authorized Official Name and Position | Linda C Leckman (CEO INTERMOUNTAIN MEDICAL GROUP) |
| Authorized Official Contact | 8014423974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyons Village Medical Clinic Po Box 27128 Salt Lake City UT 84127-0128 Ph: (435) 615-2235 | Canyons Village Medical Clinic 3850 Canyons Resort Dr Park City UT 84098-6546 Ph: (435) 615-2235 |
| NPI Number | 1831454446 |
|---|---|
| Provider Enumeration Date | 07/10/2012 |
| Last Update Date | 01/25/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831454446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5912012 (Utah) | Primary |
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