Healthcare Provider Details

I. General information

NPI: 1255389060
Provider Name (Legal Business Name): RICHARD KEVIN GILROY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6360 S 3000 E STE 310
SALT LAKE CITY UT
84121-6939
US

IV. Provider business mailing address

1187 E 3900 S
SALT LAKE CITY UT
84124-1201
US

V. Phone/Fax

Practice location:
  • Phone: 801-944-3144
  • Fax:
Mailing address:
  • Phone: 801-944-3144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number9692229-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: