Provider Demographics
NPI:1245505973
Name:UTAH VALLEY URGENT CARE PLLC
Entity type:Organization
Organization Name:UTAH VALLEY URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:801-766-9822
Mailing Address - Street 1:127 E MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-2288
Mailing Address - Country:US
Mailing Address - Phone:801-766-9822
Mailing Address - Fax:801-766-9441
Practice Address - Street 1:960 W 800 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3626
Practice Address - Country:US
Practice Address - Phone:801-766-9822
Practice Address - Fax:801-766-9441
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UTAH VALLEY URGENT CARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000069706Medicare PIN