Organization
IHC HEALTH SERVICES INC
Active
Other names
Avenues Specialty Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA C LECKMAN MD (CEO INTERMOUNTAIN MEDICAL GROUP)
(801) 442-3974
Entity
Organization
Contact information
Practice address
324 10TH AVE, #200, SALT LAKE CITY, UT 84103-2853
(801) 408-7500
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-7500
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
6312010
UT
207R00000X
Internal Medicine Physician
Primary
20040897
UT
207RG0100X
Gastroenterology Physician
6312010
UT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
20040897
UT
207V00000X
Obstetrics & Gynecology Physician
6312010
UT
208600000X
Surgery Physician
6312010
UT
208800000X
Urology Physician
6312010
UT
Other
Enumeration date
02/21/2007
Last updated
09/03/2010
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