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NPI Code Detail

MEDICARE: JEFFERY G GARDNER M.D.

MEDICARE: JEFFERY G GARDNER 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
1207P00000XEmergency Medicine Physician4301084561MI

General Provider Information

NPI Number : 1447285903
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFERY G GARDNER M.D.
Provider Business Mailing Address
First Line : 2151 W SUNSET POINTE DR
Second Line :
City : CEDAR CITY
State : UT
Zip : 84720-1813
Country : US
Telephone Number : 435-267-2224
Fax Number :
Provider Business Practice Location Address
First Line : 2151 W SUNSET POINTE DR
Second Line :
City : CEDAR CITY
State : UT
Zip : 84720-1813
Country : US
Telephone Number : 435-267-2224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 03/20/2008

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