Provider Demographics
NPI:1346351632
Name:YAUNEY, K. DUFF (MD)
Entity Type:Individual
Prefix:
First Name:K. DUFF
Middle Name:
Last Name:YAUNEY
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 1:1954 FORT UNION BLVD
Mailing Address - Street 2:111
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6800
Mailing Address - Country:US
Mailing Address - Phone:801-993-9551
Mailing Address - Fax:801-733-5872
Practice Address - Street 1:100 N MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113-1103
Practice Address - Country:US
Practice Address - Phone:801-588-3272
Practice Address - Fax:801-588-3279
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT287349-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0153231Medicaid
UT219175OtherALTIUS
UT851322OtherDESERET MUTUAL
UT78900OtherPEHP
UT8941232OtherCRIME VICTIMS REPARATION
UT107029676101OtherIHC
UTTPRA09241OtherMOLINA
UT28734912000001OtherBCBS
AZ750580Medicaid
UT87280OtherHEALTHY U