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General NPI Number Information
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NPI Number | 1154515765
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Entity Type | Individual
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Provider Name | TIMOTHY J GAYOWSKI MD FACS
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Gender | Male
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 144 S 500 E
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-1907
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Country | US
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Telephone | 775-222-0043
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Fax | 800-704-8908
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Provider Business Mailing Address
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Address Line | DEPARTMENT OF SURGERY 30 NORTH 1900 EAST #3B110 SOM
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-0001
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Country | US
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Telephone | 801-581-6171
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Fax | 801-581-4359
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | 6668569-8905
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 6668569-1205
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License Number State | UT
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