Provider Demographics
NPI:1003287970
Name:HYNDMAN, MARLENE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:
Last Name:HYNDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 S 600 W
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8204
Mailing Address - Country:US
Mailing Address - Phone:801-298-4889
Mailing Address - Fax:
Practice Address - Street 1:3024 S 600 W
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-8204
Practice Address - Country:US
Practice Address - Phone:801-298-4889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6631A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine