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General NPI Number Information
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NPI Number | 1598761090
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW FOOT AND ANKLE SPECIALISTS INC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1030 S MEDICAL DR STE A
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City | BRIGHAM CITY
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State | UT
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Zip | 84302-3119
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Country | US
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Telephone | 435-723-9700
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Fax | 435-723-9710
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Provider Business Mailing Address
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Address Line | PO BOX 540610
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City | N SALT LAKE
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State | UT
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Zip | 84054-0610
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Country | US
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Telephone | 801-505-0821
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Fax | 801-505-0803
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Authorized Official
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Title or Position | PRESIDENT
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Name | SPENCER BOWEN HENINGER
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Credential | D.P.M.
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Telephone | 435-881-4494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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