Provider Demographics
NPI:1871948653
Name:TEYNOR PHYSICIANS GROUP PLLC
Entity type:Organization
Organization Name:TEYNOR PHYSICIANS GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:TEYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-285-8350
Mailing Address - Street 1:4538 S BROCKBANK DR
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3912
Mailing Address - Country:US
Mailing Address - Phone:385-285-8350
Mailing Address - Fax:516-531-8730
Practice Address - Street 1:2290 E 4500 S STE 180
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-4493
Practice Address - Country:US
Practice Address - Phone:385-285-8350
Practice Address - Fax:516-531-8730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty