Provider Demographics
NPI:1780646265
Name:MARSDEN, CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:MARSDEN
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: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:
Mailing Address - Fax:
Practice Address - Street 1:5121 S COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-507-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT279631-1205207P00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD1203Medicaid
UT005567234Medicare ID - Type Unspecified5475 S 500 E, OGDEN
UT005568636Medicare ID - Type Unspecified1050 E SOUTH TEMPLE, SLC
UT005568443Medicare ID - Type Unspecified3580 W 9000 S, W JORDA
UTD1203Medicaid
UT005568350Medicare ID - Type Unspecified3460 PIONEER PKWY, WVC
UT005568550Medicare ID - Type Unspecified630 MEDICAL DR, BOUNTIFUL
UT005567139Medicare ID - Type Unspecified1600 ANTELOPE DR, LATYON