Healthcare Provider Details

I. General information

NPI: 1902873425
Provider Name (Legal Business Name): PAUL R. REAY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 WEST 100 NORTH
MONTICELLO UT
84535-0308
US

IV. Provider business mailing address

1797 CHEROKEE DR
PLEASANT GROVE UT
84062-3322
US

V. Phone/Fax

Practice location:
  • Phone: 435-587-2116
  • Fax:
Mailing address:
  • Phone: 801-796-5954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4881191-1204
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4881191-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: