Provider Demographics
NPI:1811028160
Name:MATTINGLY, DEBORAH LYNN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNN
Last Name:MATTINGLY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:3159 OAKCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-5675
Mailing Address - Country:US
Mailing Address - Phone:801-699-9025
Mailing Address - Fax:801-272-2942
Practice Address - Street 1:2390 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-2027
Practice Address - Country:US
Practice Address - Phone:801-975-1600
Practice Address - Fax:801-975-1666
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT18475812052083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine