# ST. MARK'S SOUTH JORDAN FAMILY PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Jordan Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982871828
- **Authorized official:** MR. DAVID J. KANE (VP)
- **Authorized official phone:** (801) 568-5999

## Contact information

- **Practice address:** 10623 S REDWOOD RD, SUITE 101, SOUTH JORDAN, UT 84095-2481
- **Practice address phone:** (801) 302-0899
- **Practice address fax:** (801) 302-0892
- **Mailing address:** 10623 S REDWOOD RD, SUITE 101, SOUTH JORDAN, UT 84095-2481
- **Mailing address phone:** (801) 302-0899
- **Mailing address fax:** (801) 302-0892

## Taxonomy

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

## Other

- **Enumeration date:** 05/09/2008
- **Last updated:** 05/20/2010