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General NPI Number Information
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NPI Number | 1184898140
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Entity Type | Individual
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Provider Name | LAYFE ROBERT ANTHONY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/21/2008
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Last Update Date | 04/21/2008
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Provider Practice Location Address
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Address Line | 1850 S 300 W SUITE A
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-2398
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Country | US
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Telephone | 801-484-5504
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 WASATCH DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84108-2441
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Country | US
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Telephone | 801-859-4145
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2767441205
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License Number State | UT
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