# CRESTWOOD MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CRESTWOOD MEDICAL GROUP INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578732137
- **Legal business name:** CRESTWOOD MEDICAL GROUP INC
- **Authorized official:** DR. JOHN B TAYLOR MD (PRESIDENT OWNER)
- **Authorized official phone:** (801) 546-1273

## Contact information

- **Practice address:** 47 CRESTWOOD RD, STE \#2, KAYSVILLE, UT 84037-1445
- **Practice address phone:** (801) 546-1273
- **Practice address fax:** (801) 546-1631
- **Mailing address:** 47 CRESTWOOD RD, STE \#2 CRESTWOOD MEDICAL GROUP, KAYSVILLE, UT 84037-1445
- **Mailing address phone:** (801) 546-1273
- **Mailing address fax:** (801) 546-1631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 161981-1205 | UT | Yes |

## Other

- **Enumeration date:** 02/27/2008
- **Last updated:** 02/27/2008