Healthcare Provider Details

I. General information

NPI: 1902805500
Provider Name (Legal Business Name): RODNEY A. POLLARY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2978 N DESERT FOREST LN
LEHI UT
84043-6520
US

IV. Provider business mailing address

2978 N DESERT FOREST LN
LEHI UT
84043-6520
US

V. Phone/Fax

Practice location:
  • Phone: 801-885-0309
  • Fax: 801-823-0784
Mailing address:
  • Phone: 801-885-0309
  • Fax: 435-789-7754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number158042-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: