NPIMap

Organization Active NPI

Physician Group of Utah Inc

  • Obstetrics & Gynecology Physician
  • Layton, UT
National Provider Identifier
1033671540
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PHYSICIAN GROUP OF UTAH INC
Practice address
1580 W Antelope Dr Ste 290
Layton, UT 84041-1179
Phone
(801) 776-0880
Fax
(801) 773-7399
NPI assigned
Apr 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tyler K Wilko
Title
Ceo
Phone
(801) 984-3293

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1580 W Antelope Dr Ste 290
Layton, UT 84041-1179

Mailing address

PO Box 281415
Atlanta, GA 30384-1415
Phone (800) 673-1270

Other names 1

  • STEWARD MEDICAL GROUP OF UTAH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Physician Group of Utah Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1033671540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281415",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841415",
            "telephone_number": "800-673-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 W ANTELOPE DR STE 290",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411179",
            "telephone_number": "801-776-0880",
            "fax_number": "801-773-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN GROUP OF UTAH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "WILKO",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-984-3293"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEWARD MEDICAL GROUP OF UTAH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.