Custom Medical Services

Organization Active
NPI 1669452298
Adolescent Medicine (Family Medicine) Physician Roosevelt, UT

Custom Medical Services holds NPI 1669452298, with a primary taxonomy of adolescent medicine (family medicine) physician and a practice location in Roosevelt, UT. The number was issued on January 19, 2006 and the NPPES record was last updated on September 11, 2025. The record lists 4 taxonomy codes.

Taxonomies and licenses

TaxonomyCodeLicense
Adolescent Medicine (Family Medicine) Physician Primary 207QA0000X Not listed
Legal Medicine 173000000X V09531 (UT)
Adult Medicine Physician 207QA0505X V09531 (UT)
Geriatric Medicine (Family Medicine) Physician 207QG0300X Not listed

Practice location

Rr 3 Box 3053
Roosevelt, UT 84066-9609
Phone: (435) 722-7704

Local context

Active NPPES records list 1 provider with adolescent medicine (family medicine) physician as the primary taxonomy within 25 miles of this practice location's ZIP code.

The same primary taxonomy is listed by 3 in Utah and 272 nationwide.

These are counts from NPPES records, not a ranking or recommendation. Distances are measured between ZIP code centers, not street addresses.

Record history

Status
Active
NPI issued
Last updated in NPPES

Is this your record? Updates are made through NPPES, the official National Plan and Provider Enumeration System.

NPPES data as of · Source: CMS NPPES

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