Provider Demographics
NPI:1689553158
Name:UTAH MEDICAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:UTAH MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:385-340-3130
Mailing Address - Street 1:41 E 400 N # 332
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4020
Mailing Address - Country:US
Mailing Address - Phone:385-340-3130
Mailing Address - Fax:
Practice Address - Street 1:1455 S 500 W STE B
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-8252
Practice Address - Country:US
Practice Address - Phone:385-340-3130
Practice Address - Fax:435-355-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center