MEDICARE: LAYFE ROBERT ANTHONY 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	207Q00000X	Family Medicine Physician	2767441205	UT

General Provider Information

NPI Number	:	1184898140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAYFE ROBERT ANTHONY M.D.

Provider Business Mailing Address
First Line	:	1303 WASATCH DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-2441
Country	:	US
Telephone Number	:	801-859-4145
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 S 300 W
Second Line	:	SUITE A
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-2398
Country	:	US
Telephone Number	:	801-484-5504
Fax Number	:

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

Provider Enumeration Date	:	04/21/2008
Last Update Date	:	04/21/2008

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