Southridge Clinic Surgical Specialties - Primary Care in Riverton, UT

Southridge Clinic Surgical Specialties is a primary clinic (Pediatrics) in Riverton, Utah. The current practice location for Southridge Clinic Surgical Specialties is 3723 W 12600 S, #270, Riverton, Utah. For appointments, you can reach them via phone at (801) 285-4600. The mailing address for Southridge Clinic Surgical Specialties is Po Box 27128, Salt Lake City, Utah and phone number is (801) 285-4600.

Southridge Clinic Surgical Specialties is licensed to practice in Utah (license number 2005200) and its NPI number is 1659401537. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (801) 285-4600.

Contact Information

Southridge Clinic Surgical Specialties
3723 W 12600 S
#270
Riverton
UT 84065-7296
(801) 285-4600
Not Available

Primary Care Clinic Profile

Full NameSouthridge Clinic Surgical Specialties
SpecialityPediatrics
Location3723 W 12600 S, Riverton, Utah
Authorized Official Name and PositionLinda C Leckman (CEO INTERMOUNTAIN MEDICAL GROUP)
Authorized Official Contact8014423974
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Southridge Clinic Surgical Specialties
Po Box 27128
Salt Lake City
UT 84127-0128

Ph: (801) 285-4600
Southridge Clinic Surgical Specialties
3723 W 12600 S
#270
Riverton
UT 84065-7296

Ph: (801) 285-4600

NPI Details:

NPI Number1659401537
Provider Enumeration Date03/07/2007
Last Update Date01/19/2017

Medical Identifiers

Medical identifiers for Southridge Clinic Surgical Specialties such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1659401537NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 2005200 (Utah)Secondary
207V00000XObstetrics & Gynecology 2005200 (Utah)Secondary
208000000XPediatrics 2005200 (Utah)Primary

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