Organization
MOUNTAIN VISTA MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE T SWINYARD MD (OWNER)
(801) 838-9090
Entity
Organization
Contact information
Practice address
1258 W SOUTH JORDAN PKWY, 103, SOUTH JORDAN, UT 84095
(801) 838-9090
(801) 838-9092
Mailing address
1258 W SOUTH JORDAN PKWY, 103, SOUTH JORDAN, UT 84095-4711
(801) 838-9090
(801) 838-9092
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
292580-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245222819
INDIVDUAL NPI
—
Enumeration date
08/09/2012
Last updated
07/02/2018
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