Provider Demographics
NPI:1790726487
Name:MORLEY, H GARY (DPM)
Entity Type:Individual
Prefix:DR
First Name:H GARY
Middle Name:
Last Name:MORLEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 N UNIVERSITY AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-7123
Mailing Address - Country:US
Mailing Address - Phone:801-374-6900
Mailing Address - Fax:801-374-6901
Practice Address - Street 1:1275 N UNIVERSITY AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-7123
Practice Address - Country:US
Practice Address - Phone:801-374-6900
Practice Address - Fax:801-374-6901
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT221015370501213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT$$$$$$$$$001Medicaid
UTT48856Medicare UPIN
UT$$$$$$$$$001Medicaid
UT000004921Medicare PIN