Provider Demographics
NPI:1043874324
Name:VALDEZ, MARCOS D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:D
Last Name:VALDEZ
Suffix:
Gender:M
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:PO BOX 1437
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-1437
Mailing Address - Country:US
Mailing Address - Phone:435-613-2200
Mailing Address - Fax:435-613-2201
Practice Address - Street 1:377 N FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4241
Practice Address - Country:US
Practice Address - Phone:435-613-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12187373-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine