Provider Demographics
NPI:1619392586
Name:GILES, ALTON (PARAMEDIC)
Entity Type:Individual
Prefix:MR
First Name:ALTON
Middle Name:
Last Name:GILES
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9567 S MISTY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-3303
Mailing Address - Country:US
Mailing Address - Phone:801-580-5727
Mailing Address - Fax:385-212-2003
Practice Address - Street 1:9567 S MISTY OAKS CIR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-3303
Practice Address - Country:US
Practice Address - Phone:801-580-5727
Practice Address - Fax:385-212-2003
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1992016009146L00000X
UT150143702172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No172A00000XOther Service ProvidersDriver