MEDICARE: DR. MEGAN C PHELPS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	14205133-1205	UT
2	207Q00000X	Family Medicine Physician	MRM-2142	ID

General Provider Information

NPI Number	:	1043956949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN C PHELPS MD

Provider Business Mailing Address
First Line	:	1455 W 2200 S STE 300
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-7219
Country	:	US
Telephone Number	:	801-412-6920
Fax Number	:	877-497-4661

Provider Business Practice Location Address
First Line	:	220 W 7200 S STE A
Second Line	:
City	:	MIDVALE
State	:	UT
Zip	:	84047-1053
Country	:	US
Telephone Number	:	801-566-5494
Fax Number	:	877-497-4661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2022
Last Update Date	:	12/29/2025

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