Organization
INTERCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BUNN (OWNER/PHYSICIAN)
(801) 704-5027
Entity
Organization
Contact information
Practice address
1317 E 750 N, OREM, UT 84097-5480
(801) 704-5027
(801) 367-7678
Mailing address
6694 W. NORMANDY WAY, HIGHLAND, UT 84003
(801) 704-5027
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5756680-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO195129
OREGON MEDICAL LICESNSE
OR
Enumeration date
05/11/2011
Last updated
08/12/2024
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