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NPI Code Detail

MEDICARE: DR. SIMON ANTHONY MARTIN M.D.

MEDICARE: DR. SIMON ANTHONY MARTIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician14188239-1205UT
2207L00000XAnesthesiology Physician14188239-8905UT

General Provider Information

NPI Number : 1508399809
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIMON ANTHONY MARTIN M.D.
Provider Business Mailing Address
First Line : HELIX BUILDING 5050
Second Line : 30 N MARIO CAPECCHI DRIVE
City : SALT LAKE CITY
State : UT
Zip : 84112-9049
Country : US
Telephone Number : 801-581-6393
Fax Number :
Provider Business Practice Location Address
First Line : 50 N MEDICAL DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84132-0001
Country : US
Telephone Number : 801-581-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2017
Last Update Date : 04/14/2026

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