Healthcare Provider Details

I. General information

NPI: 1396773834
Provider Name (Legal Business Name): IHC HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4403 HARRISON BLVD STE 3650
OGDEN UT
84403-3271
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-7125
  • Fax: 801-387-7130
Mailing address:
  • Phone: 801-387-7125
  • Fax: 801-387-7130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA C LECKMAN
Title or Position: CEO INTERMOUNTAIN MEDICAL GROUP
Credential: MD
Phone: 801-442-3974