Healthcare Provider Details

I. General information

NPI: 1841745171
Provider Name (Legal Business Name): FRANK ARCHER, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 N 100 E
SPANISH FORK UT
84660-1802
US

IV. Provider business mailing address

24 N 100 E
SPANISH FORK UT
84660-1802
US

V. Phone/Fax

Practice location:
  • Phone: 801-429-8000
  • Fax: 385-888-9171
Mailing address:
  • Phone: 801-429-8000
  • Fax: 385-888-9171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6701075-1205
License Number StateUT

VIII. Authorized Official

Name: FRANK ARCHER
Title or Position: SOLE MEMBER
Credential: MD
Phone: 801-429-8000