Organization · Type 2 NPI

FJM Basecamp

Family Medicine Physician · Salt Lake City, UT

NPI number 1255858734 Active

Practice location

185 S State St Ste 208
Salt Lake City, UT 84111-1558

Call (801) 821-5454 Map

Fax (801) 821-5455

Mailing address

560 S 300 E Ste 275
Salt Lake City, UT 84111-3586

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	70786441205 (UT)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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NPI record

NPI: 1255858734
Entity type: Organization (Type 2)
Issued: Aug 25, 2017
Last updated: Jul 21, 2022
Status: Active
Subpart: Yes of Futura Medical Clinic

Other names

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FJM Medical Clinic-Basecamp · doing business as

Authorized official

Darce A Latsis
Operations Manager
(801) 441-1002

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1255858734

FJM Basecamp's National Provider Identifier is 1255858734, issued on Aug 25, 2017. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Salt Lake City, UT. The record was last updated on Jul 21, 2022.