Provider Demographics
NPI:1679533343
Name:MACFARLANE, JOHN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:MACFARLANE
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 1:5171 S COTTONWOOD ST STE 910
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5704
Mailing Address - Country:US
Mailing Address - Phone:801-507-9800
Mailing Address - Fax:801-507-9909
Practice Address - Street 1:5171 COTTONWOOD ST
Practice Address - Street 2:SUITE 950
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5704
Practice Address - Country:US
Practice Address - Phone:801-507-9555
Practice Address - Fax:801-507-9550
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1839181205207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTG28832Medicare UPIN
UTP00065522Medicare ID - Type UnspecifiedRAILROAD MEDICARE
UT005728303Medicare ID - Type UnspecifiedUTAH MEDICARE