| Park City Specialty | |
|
900 Round Valley Dr Ste 200 Park City UT 84060-7532 | |
| (435) 658-7400 | |
| Not Available |
| Full Name | Park City Specialty |
|---|---|
| Speciality | Internal Medicine |
| Location | 900 Round Valley 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 |
|---|---|
| Park City Specialty Po Box 27128 Salt Lake City UT 84127-0128 Ph: (435) 658-7400 | Park City Specialty 900 Round Valley Dr Ste 200 Park City UT 84060-7532 Ph: (435) 658-7400 |
| NPI Number | 1205066495 |
|---|---|
| Provider Enumeration Date | 07/22/2009 |
| Last Update Date | 02/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205066495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 5812009 (Utah) | Primary |
| 207V00000X | Obstetrics & Gynecology | 5812009 (Utah) | Secondary |
| 208600000X | Surgery | 2512009 (Virginia) | Secondary |
Park City Clinic-round Valley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 Round Valley Dr, Park City, UT 84060 Phone: 866-743-2584 | |
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