LIVING TREE MEDICAL GROUP NPI 1639754583

NPI Information

  • NPI: 1639754583
  • Provider Name: LIVING TREE MEDICAL GROUP
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 46D2246257
  • Address: 1635 N 200 E
    LOGAN, UT
    ZIP 84341
  • Phone: (435) 565-6043

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NPI Details

LIVING TREE MEDICAL GROUP is a family medicine in Logan, UT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LIVING TREE MEDICAL GROUP NPI is 1639754583. The provider is registered as an organization entity type.

The provider's business location address is:

1635 N 200 E
LOGAN, UT
ZIP 84341-913
Phone: (435) 565-6043
Fax: (435) 215-4420

The provider's authorized official is Kris Coleman .
The authorized official title is Coc and has the following contact phone number (435) 770-2131.

The CLIA number assigned to this NPI record is 46D2246257 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/12/2021 and was last updated on 7/11/2025.

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
1261QH0100XClinic/CenterHealth ServiceNo
2207Q00000XFamily MedicineYes

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: 11/21/2025

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