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NPI Code Detail

MEDICARE: DR. CLAYTON SCOTT SYNDERGAARD DO

MEDICARE: DR. CLAYTON SCOTT SYNDERGAARD DO
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
1207V00000XObstetrics & Gynecology Physician6820891UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134106784
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLAYTON SCOTT SYNDERGAARD DO
Provider Business Mailing Address
First Line : 1140 W 500 S STE 9
Second Line :
City : VERNAL
State : UT
Zip : 84078-2912
Country : US
Telephone Number : 435-725-6300
Fax Number : 435-725-6325
Provider Business Practice Location Address
First Line : 1140 W 500 S STE 9
Second Line :
City : VERNAL
State : UT
Zip : 84078-2912
Country : US
Telephone Number : 435-725-6300
Fax Number : 435-725-6325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2005
Last Update Date : 09/02/2021

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