Bridge Utah Medical Group

LBN: Bridge Utah Medical Group
Bridge Utah Medical Group is an health care organization with primary practice located at 1015 E 100 N , Logan UT 84321-4873. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is the primary health care specialty. Bridge Utah Medical Group can be contacted via phone (888) 221-0423, or through Peterson, Cameron G via phone (801) 598-8337.

Contact Information

Primary practice address
1015 E 100 N Logan UT 84321-4873
Phone: (888) 221-0423
Fax: (888) 221-9816
Website:
Map and Directions
Authorized official contact:
Name: Peterson, Cameron G Doctor of Medicine (MD)
Phone: (801) 598-8337

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X

Profile Details

NPI number 1104324904
LBN Legal business name Bridge Utah Medical Group
DBA Doing business as
Authorized official Peterson, Cameron G Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 26th, 2018
Last updated Mar 14th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104324904 NPPES
Utah MEDICAID 0000

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