# ASHLEY VALLEY PHYSICIAN PRACTICE, LLC

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

## Provider details

- **NPI number:** 1740482025
- **Authorized official:** CHARLOTTE LAWRENCE (SECRETARY)
- **Authorized official phone:** (615) 920-7000

## Contact information

- **Practice address:** 175 N. 100 W., SUITE 202, VERNAL, UT 84078
- **Practice address phone:** (435) 789-1820
- **Practice address fax:** (435) 789-1821
- **Mailing address:** 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
- **Mailing address phone:** (615) 920-7000
- **Mailing address fax:** (615) 920-8775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | 4914584-1205 | UT | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 09/18/2024