Organization · Type 2 NPI
Legacy Dermatology
Medical Specialty Clinic/Center · Bountiful, UT
Practice location
320 W 500 S, Suite 210
Bountiful, UT 84010-7218
Fax (385) 743-3333
Mailing address
1535 Lakeview Dr
Bountiful, UT 84010-1561
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | 9017921-1204 (UT) |
Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Other medical specialty clinic/center providers in Bountiful
About NPI 1376944942
Legacy Dermatology's National Provider Identifier is 1376944942, issued on Sep 14, 2014. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Bountiful, UT. The record was last updated on Sep 14, 2014.