Healthcare Provider Details

I. General information

NPI: 1891998852
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4403 HARRISON BLVD #4815
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: 801-387-8350
  • Fax:
Mailing address:
  • Phone: 801-779-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1013058
License Number StateUT

VIII. Authorized Official

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