Tri City Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TRI CITY MEDICAL CLINIC INC

Practice address

830 N 2000 W
Pleasant Grove, UT 84062-4047

Phone

(801) 756-3511

Fax

(801) 756-1705

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marshall F Willis, MD

Title

Ceo

Phone

(801) 756-3511

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275004800000",
    "number": "1144321027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 N 2000 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840624047",
            "telephone_number": "801-756-3511",
            "fax_number": "801-756-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 N 2000 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840624047",
            "telephone_number": "801-756-3511",
            "fax_number": "801-756-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI CITY MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-05-28",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-756-3511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Pleasant Grove, UT
• Providers in Pleasant Grove, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; 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.