Healthcare Provider Details

I. General information

NPI: 1750725735
Provider Name (Legal Business Name): PREMIER FAMILY MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 N 2000 W
PLEASANT GROVE UT
84062-4047
US

IV. Provider business mailing address

275 W 200 N
LINDON UT
84042-5009
US

V. Phone/Fax

Practice location:
  • Phone: 801-756-3511
  • Fax: 801-756-1705
Mailing address:
  • Phone: 801-769-2571
  • Fax: 801-443-1164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER GUYMON
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 801-769-2571