# JORDAN LANDING FAMILY MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jordan Landing Clinic LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962606657
- **Authorized official:** BRENTEN CLARK PUGH (CEO)
- **Authorized official phone:** (801) 280-7774

## Contact information

- **Practice address:** 3895 W 7800 S SUITE 100, WEST JORDAN, UT 84088-1966
- **Practice address phone:** (801) 280-7774
- **Mailing address:** 3895 W 7800 S SUITE 100, WEST JORDAN, UT 84088-1966
- **Mailing address phone:** (801) 280-7774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 50540301205 | UT | Yes |

## Other

- **Enumeration date:** 06/14/2007
- **Last updated:** 09/25/2019