Provider Demographics
NPI:1750091781
Name:PYRAMIS MEDICAL
Entity type:Organization
Organization Name:PYRAMIS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-465-4999
Mailing Address - Street 1:867 S 500 W
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-3201
Mailing Address - Country:US
Mailing Address - Phone:801-465-4999
Mailing Address - Fax:801-465-7980
Practice Address - Street 1:800 N 100 E
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-5577
Practice Address - Country:US
Practice Address - Phone:801-465-4999
Practice Address - Fax:801-465-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty