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Organization
PEACHTREE FAMILY MEDICINE PC
Active
Organization
PEACHTREE FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERA B CARLSON MD (MD)
(435) 752-5553
Entity
Organization
Contact information
Practice address
565 W 465 N STE 130, PROVIDENCE, UT 84332-4802
(435) 752-5553
(435) 755-5043
Mailing address
169 N GATEWAY DR, 170, PROVIDENCE, UT 84332-9855
(435) 752-5553
(435) 755-5043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5916429-1205
UT
Other
Enumeration date
02/22/2007
Last updated
11/06/2024
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