Healthcare Provider Details

I. General information

NPI: 1720399975
Provider Name (Legal Business Name): JOSEPH EDWARD TONNA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N MEDICAL DR
SALT LAKE CITY UT
84132-0001
US

IV. Provider business mailing address

PO BOX 510726
SALT LAKE CITY UT
84151-0726
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-2292
  • Fax: 801-581-4655
Mailing address:
  • Phone: 801-213-3900
  • Fax: 801-585-3655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number9055089-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9055089-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: