Provider Demographics
NPI:1598081325
Name:MCCAUGHEY, CORT D (MD)
Entity Type:Individual
Prefix:DR
First Name:CORT
Middle Name:D
Last Name:MCCAUGHEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CORTNEY
Other - Middle Name:D
Other - Last Name:MCCAUGHEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:441 E 2170 N
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-1873
Mailing Address - Country:US
Mailing Address - Phone:435-881-6862
Mailing Address - Fax:
Practice Address - Street 1:1350 N 500 E
Practice Address - Street 2:INTERMOUNTAIN BUDGE CLINIC
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341
Practice Address - Country:US
Practice Address - Phone:435-716-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT390200000X
UT8966644-8905207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program