Healthcare Provider Details

I. General information

NPI: 1336727882
Provider Name (Legal Business Name): LAUREN FAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN JONES

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MARIO CAPECCHI DR 3RD FLOOR SOUTH, DEPT OF INTERNAL MEDICINE
SALT LAKE CITY UT
84112
US

IV. Provider business mailing address

1741 E MURRAY HOLLADAY RD APT C408
MILLCREEK UT
84117-5580
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-7822
  • Fax:
Mailing address:
  • Phone: 435-660-1445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number14199330-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number14199330-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: