Healthcare Provider Details

I. General information

NPI: 1083789689
Provider Name (Legal Business Name): FIRST PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 24TH ST SUITE 435C
OGDEN UT
84401-1431
US

IV. Provider business mailing address

298 24TH ST SUITE 435C
OGDEN UT
84401-1431
US

V. Phone/Fax

Practice location:
  • Phone: 801-782-3060
  • Fax: 801-334-8499
Mailing address:
  • Phone: 801-782-3060
  • Fax: 801-334-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number176103-1202
License Number StateUT

VIII. Authorized Official

Name: DR. STEPHEN COPE TAYLOR
Title or Position: CHIROPRACTOR OWNER
Credential: D.C.
Phone: 801-782-3060