MEDICARE: DR. ZACHARY REGAN KRAHN 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	10682207-1205	UT

General Provider Information

NPI Number	:	1518306240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZACHARY REGAN KRAHN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 30180
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84130-0180
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5217 S STATE ST
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-4813
Country	:	US
Telephone Number	:	801-313-4118
Fax Number	:

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

Provider Enumeration Date	:	06/16/2013
Last Update Date	:	02/02/2022

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