OrganizationActive
Legacy Dermatology
NPI 1376944942 · Medical Specialty Clinic/Center · Bountiful, UT
Provider details
- NPI number
- 1376944942
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jared Heaton, Physician(435) 770-9247
- License
- 9017921-1204 (UT)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
320 W 500 S
Suite 210
Bountiful, UT 84010-7218
Phone: (385) 312-0650
Fax: (385) 743-3333
Approximate (ZIP-level) locationGet directions
Mailing address
1535 Lakeview Dr
Bountiful, UT 84010-1561
Registry dates
- Enumerated
- 2014-09-14
- Last updated
- 2014-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.