Provider Demographics
NPI:1760594337
Name:GUYMON, GARTH J (MD)
Entity Type:Individual
Prefix:
First Name:GARTH
Middle Name:J
Last Name:GUYMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:4401 HARRISON BOULEVARD
Practice Address - Street 2:MCKAY DEE HOSPITAL
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403
Practice Address - Country:US
Practice Address - Phone:801-507-5248
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT85-173248-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT36719OtherDESERET MUTUAL
UT37787OtherPEHP
UTPRA03589OtherMOLINA
UTQM0000075886OtherALTIUS
UT107006085101OtherIHC
UT1502954OtherUMWA
UT2090168OtherUNITED HEALTHCARE
UT8597445OtherWORKERS COMP
UT870545614GU1OtherEDUCATORS MUTUAL
ID003050200Medicaid
NV100501897Medicaid
WY108104700Medicaid
AZ824707Medicaid
UT53239OtherHEALTHY U
UT1502954OtherUMWA
UTC63507Medicare UPIN
AZ824707Medicaid