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General NPI Number Information
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NPI Number | 1952257503
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Entity Type | Individual
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Provider Name | SYDNEY GARDNER
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Gender | Female
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 1446 S PLEASANT GROVE BLVD
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City | PLEASANT GROVE
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State | UT
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Zip | 84062
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Country | US
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Telephone | 801-785-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 715 N 300 W
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City | AMERICAN FORK
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State | UT
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Zip | 84003
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Country | US
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Telephone | 801-227-9862
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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 | 12081015-4405
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License Number State | UT
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