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NPI Code Detail

MEDICARE: DR. JOHN DAVID MARETT MD

MEDICARE: DR. JOHN DAVID MARETT MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician6225893-1205UT

General Provider Information

NPI Number : 1821559519
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN DAVID MARETT MD
Provider Business Mailing Address
First Line : 210 W 300 N
Second Line :
City : ROOSEVELT
State : UT
Zip : 84066-2336
Country : US
Telephone Number : 435-725-7448
Fax Number :
Provider Business Practice Location Address
First Line : 250 W 300 N
Second Line :
City : ROOSEVELT
State : UT
Zip : 84066-2351
Country : US
Telephone Number : 435-725-7448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2019
Last Update Date : 07/14/2022

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Directions to “ DR. JOHN DAVID MARETT MD” Practice Location

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