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Legacy Dermatology
Medical Specialty Clinic/Center in Bountiful, Utah
NPI 1376944942

Legacy Dermatology is a Medical Specialty Clinic/Center based in Bountiful, UT and is specialized in Medical Specialty. Legacy Dermatology practices in Bountiful, UT. The NPI Number for Legacy Dermatology is 1376944942 and holds a License No. 9017921-1204 (Utah).

The current practice location address for Legacy Dermatology is 320 W 500 S, Bountiful, UT and can be reached out via phone at 385-312-0650 and via fax at 385-743-3333. You can also correspond with Legacy Dermatology through the mailing address at 1535 LAKEVIEW DR, BOUNTIFUL, UT - 84010-1561 (mailing address contact number: 435-770-9247).

Location: 320 W 500 S, Bountiful, UT, 84010-1561
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1376944942
Provider Name
Legacy Dermatology
Credential
Provider Entity Type
Organization
Address
320 W 500 S, Bountiful, UT, 84010-1561
Phone Number
385-312-0650
Fax Number
385-743-3333
Provider Enumeration Date
09/14/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
320 W 500 S
City
Bountiful
State
Utah
Zip
84010-7218
Phone Number
385-312-0650
Fax Number
385-743-3333
person
Provider Business Mailing Address Details
Address
1535 Lakeview Dr
City
Bountiful
State
Utah
Zip
84010-1561
Phone Number
435-770-9247
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
9017921-1204 (Utah)
Definition
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).
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