|
| |
|
3534 S 6000 W West Valley UT 84128-2610 | |
| (801) 969-6264 | |
| (801) 969-6333 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 3534 S 6000 W, West Valley, Utah |
| Authorized Official Name and Position | Fred M Civish (PRESIDENT) |
| Authorized Official Contact | 8019696264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3534 S 6000 W West Valley UT 84128-2610 Ph: (801) 969-6264 | 3534 S 6000 W West Valley UT 84128-2610 Ph: (801) 969-6264 |
| NPI Number | 1194860569 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194860569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 184916-1205 (Utah) | Primary |
Bridge Medical Consulting Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4501 S Hawarden Dr, West Valley, UT 84119 Phone: 801-520-1007 | |
Oquirrh Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4133 W Pioneer Pkwy Ste 130, West Valley, UT 84120 Phone: 385-337-1144 Fax: 888-546-0632 | |