Provider Demographics
NPI:1780685412
Name:ALLDREDGE, OREN CLARON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:OREN
Middle Name:CLARON
Last Name:ALLDREDGE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4400 S 700 E
Mailing Address - Street 2:#140
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3000
Mailing Address - Country:US
Mailing Address - Phone:801-288-0067
Mailing Address - Fax:801-288-0091
Practice Address - Street 1:4400 S 700 E
Practice Address - Street 2:#140
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-3000
Practice Address - Country:US
Practice Address - Phone:801-288-0067
Practice Address - Fax:801-288-0091
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
UT155564-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D99474Medicare UPIN