Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Park City Internal Medicine - Pediatrics, Lc

Organization Health Service Clinic/Center · NPI 1750569562

Park City Internal Medicine - Pediatrics, Lc is a Health Service Clinic/Center in Park City, Utah. Licensed in Utah. Registered with an NPI since 2008.

Licensed in
UT
In the registry since
2008

Practice location Address checks out

1612 Ute Blvd Ste 205
Park City, UT 84098-7500
Phone: (435) 655-3309
Fax: (435) 655-3392
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X · Licence 5151398-1205 (UT)

Record details

NPI number1750569562
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Penny Peacock — Owner · (435) 655-3309
NPI enumeratedFebruary 4, 2008
Last updated in NPPESMay 18, 2011
Mailing address1612 Ute Blvd, Ste 205, Park City, UT 84098-7500

Other providers in Park City