Shadow Mountain Family Medicine Llc

LBN: Shadow Mountain Family Medicine Llc
Shadow Mountain Family Medicine Llc is an health care organization with primary practice located at 3855 W 7800 S Suite 100, West Jordan UT 84088-5560. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Shadow Mountain Family Medicine Llc can be contacted via phone (801) 282-5952, or through Kane, David J. via phone (801) 568-5999.

Contact Information

Primary practice address
3855 W 7800 S Suite 100 West Jordan UT 84088-5560
Phone: (801) 282-5952
Fax: (801) 282-5951
Website:
Map and Directions
Authorized official contact:
Name: Kane, David J.
Phone: (801) 568-5999

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1225294697
LBN Legal business name Shadow Mountain Family Medicine Llc
DBA Doing business as
Authorized official Kane, David J.
Entity Organization
Organization subpart 1 No
Enumeration date Aug 5th, 2008
Last updated Jun 4th, 2009 - about 15 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 1225294697 NPPES
Utah MEDICAID 1225294697

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