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Organization
ELK RIDGE FAMILY PRACTICE PC
Active
Organization
ELK RIDGE FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS MICHAEL CONCOBY D.O (PRESIDENT)
(801) 465-6100
Entity
Organization
Contact information
Practice address
1172 E 100 N STE 11, PAYSON, UT 84651-1668
(801) 465-6100
(801) 465-6114
Mailing address
1172 E 100 N STE 11, PAYSON, UT 84651-1668
(801) 465-6100
(801) 465-6114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5656211-1204
UT
Other
Enumeration date
02/20/2008
Last updated
11/01/2012
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