Organization
SOUTHWEST FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL L WATSON MD (MD / OWNER)
(801) 569-9133
Entity
Organization
Contact information
Practice address
1575 W 7000 S, WEST JORDAN, UT 84084-3431
(801) 569-9133
(801) 569-9103
Mailing address
1575 W 7000 S, WEST JORDAN, UT 84084-3431
(801) 569-9133
(801) 569-9103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1756991205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000057709
GROUP MEDICARE # JULIEN
UT
01
—
000058107
MEDICARE GROUP NUMBER
UT
01
—
1174707517
GROUP / CORP NPI
UT
01
—
1316986136
NPI REBECCA LEVINE, MD
UT
01
—
1386691251
NPI KATIE JULIEN, MD
UT
01
—
1952341000
NPI
UT
Enumeration date
12/20/2007
Last updated
10/01/2008
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