Organization
SCOTT E SOUTHWORTH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT E SOUTHWORTH M.D. (PRESIDENT)
(801) 294-9333
Entity
Organization
Contact information
Practice address
520 MEDICAL DR, SUITE 200, BOUNTIFUL, UT 84010-4968
(801) 294-9333
Mailing address
140 N UNION AVE STE F-300, FARMINGTON, UT 84025-2953
(801) 294-9333
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200632514
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528924674003
—
UT
Enumeration date
11/10/2006
Last updated
12/07/2022
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