Full Name | |
---|---|
Speciality | Family Medicine |
Location | 955 E 11400 S, Sandy, 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 |
---|---|
Po Box 27128 Salt Lake City UT 84127-0128 Ph: (801) 571-0030 | 955 E 11400 S Sandy UT 84094-6946 Ph: (801) 571-0030 |
NPI Number | 1992830103 |
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Provider Enumeration Date | 02/21/2007 |
Last Update Date | 07/30/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992830103 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 55963 (Utah) | Primary |
Vernon K. Liu Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 880 E 9400 S, Suite 102, Sandy, UT 84094 Phone: 801-576-1118 Fax: 801-576-1221 | |
Utah Gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10150 S Petunia Way Ste B, Sandy, UT 84092 Phone: 801-619-9000 | |