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General NPI Number Information
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NPI Number | 1982069027
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Entity Type | Organization
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Legal Business Name | ACCUHEAL WOUND CARE
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 4159 S 2700 W
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City | TAYLORSVILLE
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State | UT
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Zip | 84129-5211
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Country | US
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Telephone | 801-671-7749
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Fax | 801-928-5359
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Provider Business Mailing Address
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Address Line | 747 SHERINGHAM CT
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City | FARMINGTON
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State | UT
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Zip | 84025-4228
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Country | US
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Telephone | 385-216-0002
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Fax | 801-928-5359
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Authorized Official
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Title or Position | PARTNER
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Name | SHERMAN B JOHNSON
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Credential | MD
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Telephone | 801-671-7749
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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 | 164667-1205
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License Number State | UT
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