# JORDAN RIDGE FAMILY MEDICINE LLC

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

## Provider details

- **NPI number:** 1770509754
- **Authorized official:** MRS. EMILY D CASTILLO (MEDICAL STAFF MANAGER)
- **Authorized official phone:** (702) 480-2550

## Contact information

- **Practice address:** 6321 S REDWOOD RD, STE 201, SALT LAKE CITY, UT 84123-6798
- **Practice address phone:** (801) 265-2212
- **Practice address fax:** (801) 265-0103
- **Mailing address:** 6321 S REDWOOD RD, SUITE 201, SALT LAKE CITY, UT 84123-6798
- **Mailing address phone:** (801) 265-2212
- **Mailing address fax:** (801) 265-0103

## Taxonomy

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

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 07/31/2023