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

Northeastern Utah Medical Group

Organization Physician Assistant · NPI 1316316482

Northeastern Utah Medical Group provides Physician Assistant services in Roosevelt, Utah. Licensed in Utah. Registered with an NPI since 2015.

Licensed in
UT
In the registry since
2015

Practice location Address checks out

250 W 300 N
Roosevelt, UT 84066-2336 Not confirmed with CMS for 11 years — call before visiting
Phone: (435) 722-4691
Fax: (435) 722-9291
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 6411766-1206 (UT)

Record details

NPI number1316316482
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationUintah Basin Medical Center
Authorized official James Marshal — Ceo · (435) 722-6162
NPI enumeratedSeptember 18, 2015
Last updated in NPPESSeptember 18, 2015
Mailing address250 W 300 N, Roosevelt, UT 84066-2336

Other providers in Roosevelt