| Smp Family Medicine, Pc | |
|
1220 E 3900 S Suite 4a Salt Lake City UT 84124-1377 | |
| (801) 747-0922 | |
| (801) 747-0924 |
| Full Name | Smp Family Medicine, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1220 E 3900 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Nicola Irene Riley (OWNER) |
| Authorized Official Contact | 8017470922 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smp Family Medicine, Pc Po Box 932 Sandy UT 84091-0932 Ph: (801) 553-9568 | Smp Family Medicine, Pc 1220 E 3900 S Suite 4a Salt Lake City UT 84124-1377 Ph: (801) 747-0922 |
| NPI Number | 1083642151 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 11/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083642151 | NPI | - | NPPES |
| 099643665001 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 56658201205 (Utah) | Primary |
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