# PREMIER FAMILY MEDICAL - EAGLE MOUNTAIN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PREMIER FAMILY MEDICAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043762479
- **Legal business name:** PREMIER FAMILY MEDICAL
- **Authorized official:** HEATHER GUYMON (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (801) 769-2571

## Contact information

- **Practice address:** 3943 E PONY EXPRESS PKWY STE 120, EAGLE MOUNTAIN, UT 84005-5543
- **Practice address phone:** (801) 756-3511
- **Practice address fax:** (801) 756-1705
- **Mailing address:** 3943 E PONY EXPRESS PKWY STE 120, EAGLE MOUNTAIN, UT 84005-5543
- **Mailing address phone:** (801) 789-5566
- **Mailing address fax:** (801) 642-2941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/02/2016
- **Last updated:** 03/22/2024