Healthcare Provider Details
I. General information
NPI: 1407098122
Provider Name (Legal Business Name): JOYCE PRITCHARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/26/2009
Last Update Date: 04/16/2013
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
685 S 670 E
OREM UT
84097-6512
US
V. Phone/Fax
- Phone: 801-569-9133
- Fax: 801-569-9103
- Phone: 801-221-9680
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 7770205-1205 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: