Healthcare Provider Details

I. General information

NPI: 1033136759
Provider Name (Legal Business Name): STEVEN VINCENT TEYNOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/23/2020
Certification Date: 12/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 S MILLROCK DR STE 125
HOLLADAY UT
84121-5794
US

IV. Provider business mailing address

3300 N TRIUMPH BLVD STE 500
LEHI UT
84043-6475
US

V. Phone/Fax

Practice location:
  • Phone: 801-821-2333
  • Fax: 801-901-1194
Mailing address:
  • Phone: 801-821-2333
  • Fax: 801-901-1194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number182847-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: