Healthcare Provider Details

I. General information

NPI: 1003174129
Provider Name (Legal Business Name): STEPHEN CRAIG MERRELL M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 W BOURNE CIR STE 101
FARMINGTON UT
84025-3657
US

IV. Provider business mailing address

PO BOX 337
LAYTON UT
84041-0337
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-4840
  • Fax: 801-525-8151
Mailing address:
  • Phone: 801-773-4840
  • Fax: 801-525-8151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8791004-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: