MEDICARE: IHC HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	208000000X	Pediatrics Physician
3	207V00000X	Obstetrics & Gynecology Physician
4	207N00000X	Dermatology Physician
5	207X00000X	Orthopaedic Surgery Physician
6	207Y00000X	Otolaryngology Physician
7	208100000X	Physical Medicine & Rehabilitation Physician
8	208600000X	Surgery Physician
9	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
10	208800000X	Urology Physician
11	2085R0001X	Radiation Oncology Physician
12	208200000X	Plastic Surgery Physician
13	363A00000X	Physician Assistant
14	363L00000X	Nurse Practitioner
15	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1306888722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IHC HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:	801-442-2997
Fax Number	:	801-442-2867

Provider Business Practice Location Address
First Line	:	36 S STATE ST
Second Line	:	MEDICAL GROUP - FINANCE DEPARTMENT
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84111-1401
Country	:	US
Telephone Number	:	801-442-2997
Fax Number	:	801-442-2867

Authorized Official
Title or Position	:	CEO / VICE PRESIDENT
Name	:	DR. LINDA C. LECKMAN
Credential	:	M.D.
Telephone Number	:	801-442-3974

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	06/08/2010

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Directions to “IHC HEALTH SERVICES INC ” Practice Location

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