Healthcare Provider Details

I. General information

NPI: 1669363438
Provider Name (Legal Business Name): MOUNTAIN VIEW FOOT AND ANKLE SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 S MAIN ST
BOUNTIFUL UT
84010-6236
US

IV. Provider business mailing address

PO BOX 540610
N SALT LAKE UT
84054-0610
US

V. Phone/Fax

Practice location:
  • Phone: 385-626-6000
  • Fax: 435-723-9710
Mailing address:
  • Phone: 801-505-0821
  • Fax: 801-505-0803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: SPENCER BOWEN HENINGER
Title or Position: DPM/OWNER
Credential:
Phone: 435-723-9700