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NPI Code Detail

MEDICARE: WENDY MARIE MACEY PA

MEDICARE: WENDY MARIE MACEY PA
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
1363A00000XPhysician Assistant4943468-1206UT

General Provider Information

NPI Number : 1295825800
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY MARIE MACEY PA
Provider Business Mailing Address
First Line : PO BOX 510708
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84151-0708
Country : US
Telephone Number : 801-587-6600
Fax Number :
Provider Business Practice Location Address
First Line : 7495 S STATE ST
Second Line :
City : MIDVALE
State : UT
Zip : 84047-2013
Country : US
Telephone Number : 801-213-9400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 12/20/2021

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Directions to “ WENDY MARIE MACEY PA” Practice Location

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