Provider Demographics
NPI:1164990321
Name:SALINA FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:SALINA FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:NUILA
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-650-7101
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:UT
Mailing Address - Zip Code:84654-0343
Mailing Address - Country:US
Mailing Address - Phone:435-529-2215
Mailing Address - Fax:534-529-2094
Practice Address - Street 1:131 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:UT
Practice Address - Zip Code:84654-1335
Practice Address - Country:US
Practice Address - Phone:435-529-2215
Practice Address - Fax:435-529-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty