Organization
MOD-DOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF MIDGLEY (OWNER / PRESIDENT)
(801) 449-9229
Entity
Organization
Contact information
Practice address
1188 W SPORTSPLEX DR STE 102, KAYSVILLE, UT 84037-6816
(801) 449-9229
(385) 325-6055
Mailing address
1188 W SPORTSPLEX DR STE 102, KAYSVILLE, UT 84037-6816
(801) 449-9229
(385) 325-6055
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/09/2024
Last updated
04/27/2026
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