Provider Demographics
NPI:1063637353
Name:GORMAN, DARCIE REASONER (MD)
Entity Type:Individual
Prefix:DR
First Name:DARCIE
Middle Name:REASONER
Last Name:GORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:DARCIE
Other - Middle Name:TERRELL
Other - Last Name:REASONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-408-7500
Mailing Address - Fax:
Practice Address - Street 1:324 E 10TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103-2853
Practice Address - Country:US
Practice Address - Phone:801-408-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6020556-1205207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine