Healthcare Provider Details

I. General information

NPI: 1518050905
Provider Name (Legal Business Name): AARON HENRI MOYAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 10/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8888 PINEVIEW DR
HUNTSVILLE UT
84317-9642
US

IV. Provider business mailing address

8888 PINEVIEW DR
HUNTSVILLE UT
84317-9642
US

V. Phone/Fax

Practice location:
  • Phone: 801-388-1561
  • Fax: 801-745-9224
Mailing address:
  • Phone: 801-388-1561
  • Fax: 801-745-9224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number37160
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: