# MMG LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mobile Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407469166
- **Authorized official:** KENNETH E NORRIS (MANAGING PARTNER)
- **Authorized official phone:** (801) 485-6166

## Contact information

- **Practice address:** 2440 S TITANIUM PL, MERIDIAN, ID 83642-6703
- **Practice address phone:** (208) 456-2659
- **Practice address fax:** (208) 454-0854
- **Mailing address:** 450 S 900 E STE 100, SALT LAKE CITY, UT 84102-2983
- **Mailing address phone:** (801) 456-6166
- **Mailing address fax:** (801) 531-1949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2020
- **Last updated:** 07/22/2022