Organization
KAYSVILLE FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN JARED POTTER MD (PRESIDENT)
(801) 543-2221
Entity
Organization
Contact information
Practice address
307 N 300 W, STE 301, KAYSVILLE, UT 84037-1852
(801) 543-2221
(801) 543-2249
Mailing address
307 N 300 W, STE 301, KAYSVILLE, UT 84037-1852
(801) 543-2221
(801) 543-2249
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57481181205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
OWNERS SSN
UT
Enumeration date
11/28/2006
Last updated
08/22/2020
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