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General NPI Number Information
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NPI Number | 1780522540
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Entity Type | Organization
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Legal Business Name | MDSI PHYSICIAN GROUP, INC.
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 1701 W 2450 S
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City | OGDEN
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State | UT
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Zip | 84401-4501
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Country | US
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Telephone | 801-337-8627
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Fax | 801-337-8627
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Provider Business Mailing Address
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Address Line | PO BOX 9039
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City | OGDEN
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State | UT
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Zip | 84409-0039
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Country | US
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Telephone | 801-337-8627
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Fax | 801-337-8627
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Authorized Official
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Title or Position | COO
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Name | JENNIFER CALLAWAY FRYER
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Credential | FRYER
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Telephone | 801-337-8627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 202C00000X
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Taxonomy Name | Independent Medical Examiner Physician
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License Number |
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License Number State |
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