Healthcare Provider Details

I. General information

NPI: 1578521308
Provider Name (Legal Business Name): RONALD W ASAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W 800 N STE 444
OREM UT
84057-6305
US

IV. Provider business mailing address

PO BOX 741729
ATLANTA GA
30374-1729
US

V. Phone/Fax

Practice location:
  • Phone: 801-714-6412
  • Fax: 801-714-6413
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number173401-1205
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier14057
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerPEHP
# 2
Identifier65169
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerINTERMOUNTAIN HEALTHCARE
# 3
Identifier870281028000
Identifier TypeMEDICAID
Identifier StateUT
Identifier Issuer
# 4
IdentifierQM0000001472
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerALTIUS HEALTH PLANS
# 5
Identifier060009803
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerPALMETTO
# 6
Identifier870281028AS1
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerEMIA
# 7
Identifier04-00356
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerUNITED HEALTHCARE
# 8
Identifier4079
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerDMBA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: