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General NPI Number Information
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NPI Number | 1952019846
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Entity Type | Organization
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Legal Business Name | MOUNTAIN ORTHOPAEDICS LLC
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 1551 RENAISSANCE TOWNE DR STE 500
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City | BOUNTIFUL
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State | UT
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Zip | 84010-7678
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Country | US
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Telephone | 801-295-7200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 33539
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City | BELFAST
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State | ME
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Zip | 04915-0613
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Country | US
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Telephone | 801-295-7200
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Fax | 801-295-4930
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Authorized Official
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Title or Position | OWNER/ PHYSICIAN
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Name | CLINT WOOTEN
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Credential | MD
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Telephone | 801-295-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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