Healthcare Provider Details

I. General information

NPI: 1295260131
Provider Name (Legal Business Name): UTAH PODIATRIC PHYSICIANS AND SURGEONS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 E 11400 S STE 104
SANDY UT
84094-6947
US

IV. Provider business mailing address

PO BOX 30015 DEPT 356
SALT LAKE CITY UT
84130-0015
US

V. Phone/Fax

Practice location:
  • Phone: 801-571-7911
  • Fax: 801-532-7544
Mailing address:
  • Phone: 801-882-2001
  • Fax: 801-532-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number7899779-0501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number7899779-0501
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number7899779-0501
License Number StateUT

VIII. Authorized Official

Name: DANIEL L PREECE
Title or Position: CHAIRMAN
Credential: DPM
Phone: 801-532-1822