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700 S Highway 99 #3 Fillmore UT 84631-5134 | |
(435) 743-5555 | |
(435) 743-5764 |
Full Name | |
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Speciality | Family Medicine |
Location | 700 S Highway 99, Fillmore, 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 |
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Po Box 27128 Salt Lake City UT 84127-0128 Ph: (435) 743-5555 | 700 S Highway 99 #3 Fillmore UT 84631-5134 Ph: (435) 743-5555 |
NPI Number | 1023159381 |
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Provider Enumeration Date | 02/09/2007 |
Last Update Date | 07/17/2008 |
Identifier | Type | State | Issuer |
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1023159381 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | B2007-49 (Utah) | Primary |
207V00000X | Obstetrics & Gynecology | B2007-49 (Utah) | Secondary |