Healthcare Provider Details

I. General information

NPI: 1417216516
Provider Name (Legal Business Name): ROBERT LEE DOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF UTAH HEALTH, DEPT OF OBGYN 30 N 1900 E, RM 2B200
SALT LAKE CITY UT
84132
US

IV. Provider business mailing address

UNIVERSITY OF UTAH HEALTH, DEPT OF OBGYN 30 N 1900 E, RM 2B200
SALT LAKE CITY UT
84132
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-3552
  • Fax:
Mailing address:
  • Phone: 801-581-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberR5855
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT201007
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number11745784-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: