NORTHEASTERN UTAH MEDICAL GROUP

ROOSEVELT, UT
NPI1982664199
Entity TypeOrganization
Authorized ContactBRENT H HALES
CFO
435-722-6164
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Additional Taxonomies207R00000X Internal Medicine
208000000X Pediatrics
208600000X Surgery
207X00000X Orthopaedic Surgery
207W00000X Ophthalmology
208100000X Physical Medicine & Rehabilitation
207N00000X Dermatology
207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine
207Y00000X Otolaryngology
207V00000X Obstetrics & Gynecology
Enumeration Date2006-03-23
Last Update Date2025-10-23
Business Address
NORTHEASTERN UTAH MEDICAL GROUP
210 W 300 N 7-3
ROOSEVELT, UT 84066
Phone number: 435-722-3971
Mailing Address
NORTHEASTERN UTAH MEDICAL GROUP
210 W 300 N
ROOSEVELT, UT 84066-2336
Phone number: 435-722-3971