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JORDAN LANDING FAMILY MEDICINE LLC NPI 1962606657


NPI Information

NPI: 1962606657
Provider Name: JORDAN LANDING FAMILY MEDICINE LLC

Doing Business As: JORDAN LANDING CLINIC LLC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 46D1015256

Address:
3895 W 7800 S SUITE 100
WEST JORDAN, UT
ZIP 84088
Phone: (801) 280-7774
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JORDAN LANDING FAMILY MEDICINE LLC is a family medicine in West Jordan, 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. JORDAN LANDING FAMILY MEDICINE LLC NPI is 1962606657. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Jordan Landing Clinic Llc.

The provider's business location address is:

3895 W 7800 S SUITE 100
WEST JORDAN, UT
ZIP 84088-966
Phone: (801) 280-7774

The provider's authorized official is Brenten Clark Pugh .
The authorized official title is Ceo and has the following contact phone number (801) 280-7774.

The CLIA number assigned to this NPI record is 46D1015256 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/14/2007 and was last updated on 9/25/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine50540301205UTAHYes

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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