MEDICARE: SCOTT D VALADEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	34401	AZ
2	2085R0202X	Diagnostic Radiology Physician	6228704-1205	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00244818	OTHER	AZ	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	86080015085259C455	OTHER	AZ	TRIWEST

General Provider Information

NPI Number	:	1114900206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT D VALADEZ M.D.

Provider Business Mailing Address
First Line	:	1055 N 500 W
Second Line	:	ATTN: CREDENTIALING
City	:	PROVO
State	:	UT
Zip	:	84604-3305
Country	:	US
Telephone Number	:	801-354-8225
Fax Number	:	801-418-0941

Provider Business Practice Location Address
First Line	:	1055 N 500 W
Second Line	:	SUITE 112
City	:	PROVO
State	:	UT
Zip	:	84604-3305
Country	:	US
Telephone Number	:	801-812-4624
Fax Number	:	801-812-4699

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	11/27/2023

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Directions to “ SCOTT D VALADEZ M.D.” Practice Location

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