Healthcare Provider Details

I. General information

NPI: 1073187258
Provider Name (Legal Business Name): VALLEY OBSTETRICS AND GYNECOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 05/28/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 E MARKET PLACE DR 3RD FLOOR
SPANISH FORK UT
84660
US

IV. Provider business mailing address

585 N 500 W
PROVO UT
84601-1548
US

V. Phone/Fax

Practice location:
  • Phone: 801-374-1801
  • Fax: 801-216-8357
Mailing address:
  • Phone: 801-374-5000
  • Fax: 801-216-8357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ADAM RASMUSSEN
Title or Position: CEO
Credential:
Phone: 801-374-1802