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169 N Gateway Dr Ste 130 Providence UT 84332-9737 | |
(435) 227-5371 | |
(385) 900-1612 |
Full Name | |
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Speciality | Family Medicine |
Location | 169 N Gateway Dr Ste 130, Providence, Utah |
Authorized Official Name and Position | Matthew Michael Hill (CEO, OWNER) |
Authorized Official Contact | 4352275371 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3105 S 225 W # A102 Nibley UT 84321-7067 Ph: (385) 222-8368 | 169 N Gateway Dr Ste 130 Providence UT 84332-9737 Ph: (435) 227-5371 |
NPI Number | 1457160376 |
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Provider Enumeration Date | 01/06/2025 |
Last Update Date | 01/23/2025 |
Identifier | Type | State | Issuer |
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1457160376 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Living Tree Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 169 N Gateway Dr Ste 170, Providence, UT 84332 Phone: 435-565-6043 Fax: 435-215-4420 | |
Peachtree Family Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 565 W 465 N Ste 130, Providence, UT 84332 Phone: 435-752-5553 Fax: 435-755-5043 | |