Healthcare Provider Details

I. General information

NPI: 1144577636
Provider Name (Legal Business Name): JOYCE PRITCHARD MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 W 7000 S
WEST JORDAN UT
84084-3431
US

IV. Provider business mailing address

1575 W 7000 S
WEST JORDAN UT
84084-3431
US

V. Phone/Fax

Practice location:
  • Phone: 801-569-9133
  • Fax: 801-569-9103
Mailing address:
  • Phone: 801-569-9133
  • Fax: 801-569-9103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7770205-1205
License Number StateUT

VIII. Authorized Official

Name: JOYCE PRITCHARD
Title or Position: PRESIDENT
Credential: MD
Phone: 801-569-9133