# PLAID EAGLE MEDICAL PLLC

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

## Provider details

- **NPI number:** 1588417117
- **Authorized official:** MARIANA HANKINS (OFFICE ADMINSTRATOR)
- **Authorized official phone:** (801) 888-1140

## Contact information

- **Practice address:** 3835 NORTHERN PIKE STE 1, MONROEVILLE, PA 15146-2132
- **Practice address phone:** (800) 640-3451
- **Mailing address:** PO BOX 1200, PLEASANT GROVE, UT 84062-1200
- **Mailing address phone:** (800) 640-3451

## Taxonomy

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

## Other

- **Enumeration date:** 04/11/2024
- **Last updated:** 11/06/2024