Healthcare Provider Details
I. General information
NPI: 1427707397
Provider Name (Legal Business Name): ALEXANDER MADSEN KNUDSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/19/2022
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
325 W CENTER ST
SPANISH FORK UT
84660-2060
US
IV. Provider business mailing address
458 N 750 E
BOUNTIFUL UT
84010-2814
US
V. Phone/Fax
- Phone: 801-894-1333
- Fax: 801-798-8513
- Phone: 801-698-2636
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 14206991-1205 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: