Healthcare Provider Details
I. General information
NPI: 1538283163
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2007
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
530 N 250 W
SALINA UT
84654
US
IV. Provider business mailing address
PO BOX 27128
SALT LAKE CITY UT
84127-0128
US
V. Phone/Fax
- Phone: 435-529-7411
- Fax:
- Phone: 435-529-7411
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 149 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 149 |
| License Number State | UT |
VIII. Authorized Official
Name: DR.
LINDA
C
LECKMAN
Title or Position: CEO INTERMOUNTAIN MEDICAL GROUP
Credential: MD
Phone: 801-442-3974