Provider Demographics
NPI:1982069027
Name:ACCUHEAL WOUND CARE
Entity Type:Organization
Organization Name:ACCUHEAL WOUND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERMAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-671-7749
Mailing Address - Street 1:747 SHERINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-4228
Mailing Address - Country:US
Mailing Address - Phone:385-216-0002
Mailing Address - Fax:801-928-5359
Practice Address - Street 1:4159 S 2700 W
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-5211
Practice Address - Country:US
Practice Address - Phone:801-671-7749
Practice Address - Fax:801-928-5359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT164667-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty