DESERT EDGE MEDICAL NPI 1588162911

NPI Information

NPI: 1588162911
Provider Name: DESERT EDGE MEDICAL
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1664 S DIXIE DR STE D201
ST GEORGE, UT
ZIP 84770
Phone: (435) 656-2995
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DESERT EDGE MEDICAL is a primary care clinic center in St George, UT. DESERT EDGE MEDICAL NPI is 1588162911. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1664 S DIXIE DR STE D201
ST GEORGE, UT
ZIP 84770
Phone: (435) 656-2995

The provider's authorized official is Ryan T Borrowman .
The authorized official title is Owner and has the following contact phone number (435) 656-2995.

The enumeration date for this NPI number is 1/31/2018 and was last updated on 3/28/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	261QP2300X	Clinic/Center	Primary Care		UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1487001442	MEDICAID	UTAH

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

NPI Synchronization or Removal

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