Healthcare Provider Details

I. General information

NPI: 1841528171
Provider Name (Legal Business Name): FAMILY FIRST CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 E 900 N
SPANISH FORK UT
84660-1232
US

IV. Provider business mailing address

78 E 900 N
SPANISH FORK UT
84660-1232
US

V. Phone/Fax

Practice location:
  • Phone: 801-794-1054
  • Fax: 801-794-1055
Mailing address:
  • Phone: 801-794-1054
  • Fax: 801-794-1055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number90-182517-1205
License Number StateUT

VIII. Authorized Official

Name: DR. DAVID TAYLOR ROBERTS SR.
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 801-794-1054