Maple Mountain Medical LLC

Organization Active NPI Family Medicine Physician · Mapleton, UT

NPI 1629816228 · NPPES record last updated Jul 17, 2024

Key facts

NPI
1629816228
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MAPLE MOUNTAIN MEDICAL LLC
Practice address
724 S 1600 W
Mapleton, UT 84664-4347
Phone
(801) 515-6048
Fax
(855) 848-5748
NPI assigned
Jul 17, 2024
Organization subpart
No

Authorized official

Name
Michael Johnson
Title
Ceo
Phone
(332) 330-3903

National Provider Directory

Locations

724 S 1600 W
Mapleton, UT 84664
Phone (801) 515-6048

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

724 S 1600 W
Mapleton, UT 84664-4347

Mailing address

724 S 1600 W
Mapleton, UT 84664-4347
Phone (801) 515-6048

Other providers in Mapleton, UT

All providers in Mapleton, UT · Family Medicine Physician in Utah

Sources for this page

Verify at the official NPI Registry.