Healthcare Provider Details

I. General information

NPI: 1043697154
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3890 MEDICAL DR
OGDEN UT
84403-2319
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-7678
  • Fax:
Mailing address:
  • Phone: 801-387-7678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number741772015
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number741772015
License Number StateUT

VIII. Authorized Official

Name: JP VALIN
Title or Position: EVP CHIEF CLINICAL OFFICER
Credential: MD
Phone: 801-442-5000