Provider Demographics
NPI:1932289121
Name:MINER, JOHN E (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:MINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:1380 EAST MEDICAL CENTER DRIVE
Practice Address - Street 2:DIXIE REGIONAL MEDICAL CENTER
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-251-1000
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2012-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT4863357-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100501242Medicaid
UT48633571200001OtherBCBS
UT73621OtherPEHP
UT71120OtherHEALTHY U
AZ821646Medicaid
WY118902600Medicaid
UT1502954OtherUMWA
UT2090168OtherUNITED HEALTHCARE
UT808956OtherDESERET MUTUAL
UT107018633101OtherIHC
ID806731800Medicaid
UTQM0000075886OtherALTIUS
UT870545614MI3OtherEDUCATORS MUTUAL
UTTPRA07507OtherMOLINA
UT2090168OtherUNITED HEALTHCARE
NV100501242Medicaid
UT808956OtherDESERET MUTUAL