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WOODMEAD MEDICAL CLINIC PLLC NPI 1194013870


NPI Information

NPI: 1194013870
Provider Name: WOODMEAD MEDICAL CLINIC PLLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
3263 S HIGHWAY 89
SUITE 300
BOUNTIFUL, UT
ZIP 84010
Phone: (801) 296-0600
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WOODMEAD MEDICAL CLINIC PLLC is a clinic center in Bountiful, UT. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). WOODMEAD MEDICAL CLINIC PLLC NPI is 1194013870. The provider is registered as an organization entity type.

The provider's business location address is:

3263 S HIGHWAY 89
SUITE 300
BOUNTIFUL, UT
ZIP 84010-555
Phone: (801) 296-0600
Fax: (801) 295-1700

The provider's authorized official is Gavin N Van Staden .
The authorized official title is Owner and has the following contact phone number (801) 296-0600.

The enumeration date for this NPI number is 7/15/2011 and was last updated on 7/15/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center284903-1205UTAHNo
2261Q00000XClinic/Center5863514-1205UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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