Organization
CRESTWOOD MEDICAL GROUP INC
Active
Parent organization
CRESTWOOD MEDICAL GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRESTWOOD MEDICAL GROUP INC
Authorized official
DR. JOHN B TAYLOR MD (PRESIDENT OWNER)
(801) 546-1273
Entity
Organization
Contact information
Practice address
47 CRESTWOOD RD, STE #2, KAYSVILLE, UT 84037-1445
(801) 546-1273
(801) 546-1631
Mailing address
47 CRESTWOOD RD, STE #2 CRESTWOOD MEDICAL GROUP, KAYSVILLE, UT 84037-1445
(801) 546-1273
(801) 546-1631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
161981-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248783020008
—
UT
Enumeration date
02/27/2008
Last updated
02/27/2008
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