Healthcare Provider Details

I. General information

NPI: 1649204553
Provider Name (Legal Business Name): UTAH VALLEY EMERGENCY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 NORTH 500 WEST ER DEPARTMENT
PROVO UT
84604
US

IV. Provider business mailing address

1034 N 500 W
PROVO UT
84604-3380
US

V. Phone/Fax

Practice location:
  • Phone: 877-346-2211
  • Fax:
Mailing address:
  • Phone: 801-253-6554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: VANESSA MUNDY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 801-253-6554