Provider Demographics
NPI:1073102901
Name:MEDICAL ACCIDENT CENTER
Entity Type:Organization
Organization Name:MEDICAL ACCIDENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:385-482-7991
Mailing Address - Street 1:1248 E 90 N STE 203
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2959
Mailing Address - Country:US
Mailing Address - Phone:385-482-7991
Mailing Address - Fax:385-498-7507
Practice Address - Street 1:1248 E 90 N STE 203
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2959
Practice Address - Country:US
Practice Address - Phone:385-498-7506
Practice Address - Fax:385-498-7507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty