Provider Demographics
NPI:1801227830
Name:FARR WEST URGENT CARE AND FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:FARR WEST URGENT CARE AND FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-732-0805
Mailing Address - Street 1:2850 N 2000 W
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404
Mailing Address - Country:US
Mailing Address - Phone:801-732-0805
Mailing Address - Fax:385-333-4233
Practice Address - Street 1:2850 N 2000 W
Practice Address - Street 2:SUITE 101
Practice Address - City:FARR WEST
Practice Address - State:UT
Practice Address - Zip Code:84404
Practice Address - Country:US
Practice Address - Phone:801-732-0805
Practice Address - Fax:385-333-4233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT274737-1205305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service