Provider Demographics
NPI:1285035014
Name:FAMILY FIRST MEDICAL PC
Entity Type:Organization
Organization Name:FAMILY FIRST MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:801-504-6421
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-7769
Mailing Address - Country:US
Mailing Address - Phone:801-504-6421
Mailing Address - Fax:801-504-6468
Practice Address - Street 1:24 N 100 E
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1802
Practice Address - Country:US
Practice Address - Phone:801-504-6421
Practice Address - Fax:801-504-6468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT198637-4405261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTP36912Medicare UPIN