MEDICARE: DR. GREGORY FOULGER KLOMP MD

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
1	207R00000X	Internal Medicine Physician	9048690-1205	UT

General Provider Information

NPI Number	:	1972834174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY FOULGER KLOMP MD

Provider Business Mailing Address
First Line	:	8830 PARLEYS LN
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84098-5125
Country	:	US
Telephone Number	:	917-622-4894
Fax Number	:

Provider Business Practice Location Address
First Line	:	8830 PARLEYS LN
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84098-5125
Country	:	US
Telephone Number	:	917-622-4894
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2010
Last Update Date	:	02/14/2025

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