Individual
DR. STACEY TOWNSEND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
672 W 400 S STE 101, SPRINGVILLE, UT 84663-3170
(801) 491-9883
(801) 489-3141
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
323367-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
323367-1205
LICENSE NUMBER
UT
Enumeration date
01/17/2007
Last updated
10/11/2023
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