Healthcare Provider Details

I. General information

NPI: 1417928649
Provider Name (Legal Business Name): MADELYN S. PALMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 W 200 S
KAMAS UT
84036-9010
US

IV. Provider business mailing address

228 W 200 S STE B
KAMAS UT
84036-9010
US

V. Phone/Fax

Practice location:
  • Phone: 385-213-0506
  • Fax: 435-783-2919
Mailing address:
  • Phone: 385-213-0506
  • Fax: 435-783-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number31038
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: