MEDICARE: CROSSROADS FAMILY MEDICINE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	173000000X	Legal Medicine

General Provider Information

NPI Number	:	1487716031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSSROADS FAMILY MEDICINE

Provider Business Mailing Address
First Line	:	1305 N COMMERCE DR STE 120
Second Line	:
City	:	SARATOGA SPRINGS
State	:	UT
Zip	:	84043-5309
Country	:	US
Telephone Number	:	801-766-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	1305 N COMMERCE DR STE 120
Second Line	:
City	:	SARATOGA SPRINGS
State	:	UT
Zip	:	84043-5309
Country	:	US
Telephone Number	:	801-766-2121
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	KAREEN ALTON
Credential	:
Telephone Number	:	801-766-2121

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	08/22/2020

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