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General NPI Number Information
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NPI Number | 1497930200
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Entity Type | Organization
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Legal Business Name | STANTON MCDONALD, MD PC
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 345 W 600 S STE 120
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City | HEBER CITY
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State | UT
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Zip | 84032-2283
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Country | US
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Telephone | 435-654-1501
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Fax | 435-654-2030
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Provider Business Mailing Address
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Address Line | 345 W 600 S STE 120
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City | HEBER CITY
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State | UT
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Zip | 84032-2283
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Country | US
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Telephone | 435-654-1501
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Fax | 435-654-2030
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANTON MCDONALD
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Credential | MD
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Telephone | 435-654-1501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 160908-1205
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License Number State | UT
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