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General NPI Number Information
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NPI Number | 1669424099
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Entity Type | Organization
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Legal Business Name | FAMILIES FIRST PEDIATRICS
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 2025 W 200 N STE 2
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City | KAYSVILLE
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State | UT
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Zip | 84037-4300
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Country | US
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Telephone | 801-773-8644
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Fax |
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Provider Business Mailing Address
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Address Line | 2084 N ROBINS DR STE A
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City | LAYTON
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State | UT
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Zip | 84041-1118
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Country | US
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Telephone | 801-773-8644
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Fax | 801-927-1591
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Authorized Official
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Title or Position | CREDENTIALING MANGER
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Name | EBONIE MARIE GONZALES
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Credential |
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Telephone | 505-850-3769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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