| Crestwood Medical Group Inc | |
|
47 Crestwood Rd Ste #2 Kaysville UT 84037-1445 | |
| (801) 546-1273 | |
| (801) 546-1631 |
| Full Name | Crestwood Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 47 Crestwood Rd, Kaysville, Utah |
| Authorized Official Name and Position | John B Taylor (PRESIDENT OWNER) |
| Authorized Official Contact | 8015461273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestwood Medical Group Inc 47 Crestwood Rd Ste #2 Crestwood Medical Group Kaysville UT 84037-1445 Ph: (801) 546-1273 | Crestwood Medical Group Inc 47 Crestwood Rd Ste #2 Kaysville UT 84037-1445 Ph: (801) 546-1273 |
| NPI Number | 1578732137 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 02/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578732137 | NPI | - | NPPES |
| 248783020008 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 161981-1205 (Utah) | Primary |
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