# LEPONT UTAH MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417465014
- **Authorized official:** MARK FIRTH MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (435) 770-4673

## Contact information

- **Practice address:** 1015 E 100 N, LOGAN, UT 84321-4873
- **Practice address phone:** (435) 770-4673
- **Mailing address:** 1015 E 100 N, LOGAN, UT 84321-4873
- **Mailing address phone:** (435) 770-4673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2018
- **Last updated:** 06/20/2018