Provider Demographics
NPI:1922066646
Name:MARRIOTT, RODNEY GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:GEORGE
Last Name:MARRIOTT
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 1:5495 S 500 E
Mailing Address - Street 2:SUITE 310
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-6923
Mailing Address - Country:US
Mailing Address - Phone:801-479-0361
Mailing Address - Fax:801-476-9015
Practice Address - Street 1:5495 S 500 E
Practice Address - Street 2:SUITE 310
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-6923
Practice Address - Country:US
Practice Address - Phone:801-479-0361
Practice Address - Fax:801-476-9015
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT06931207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT063665Medicare UPIN