Provider Demographics
NPI:1003865932
Name:AVIZONIS, VILIJA N (MD)
Entity type:Individual
Prefix:DR
First Name:VILIJA
Middle Name:N
Last Name:AVIZONIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1121 E 3900 S
Mailing Address - Street 2:SUITE C230
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1214
Mailing Address - Country:US
Mailing Address - Phone:801-266-0878
Mailing Address - Fax:801-266-2074
Practice Address - Street 1:3838 S 700 E
Practice Address - Street 2:SUITE 100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-1466
Practice Address - Country:US
Practice Address - Phone:801-281-6860
Practice Address - Fax:801-281-4822
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT176911-12052085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005717213Medicare PIN
UTE68020Medicare UPIN
UT000059110Medicare PIN
UT000062270Medicare PIN