Healthcare Provider Details

I. General information

NPI: 1528012770
Provider Name (Legal Business Name): U FAMILY HEALTH BILLING UNIVERSITY OF UTAH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 FOOTHILL DR
SALT LAKE CITY UT
84112-1106
US

IV. Provider business mailing address

PO BOX 510004
SALT LAKE CITY UT
84151-0004
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-5382
  • Fax:
Mailing address:
  • Phone: 801-587-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL K MAGILL
Title or Position: DEPARTMENT CHAIR
Credential: MD
Phone: 801-581-7294