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NPI Code Detail

MEDICARE: DR. THAD JOSEPH BARKDULL M.D.

MEDICARE: DR. THAD JOSEPH BARKDULL 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
1207Q00000XFamily Medicine Physician53652411205UT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P01065419OTHERUTRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11871524421OTHERUTALTIUS
2107025832102OTHERUTSELECT HEALTH
31106193OTHERUTDESERET HEALTHCARE TRUST
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6128704OTHERUTPEHP
71871524421OTHERUTTRICARE

General Provider Information

NPI Number : 1871524421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THAD JOSEPH BARKDULL M.D.
Provider Business Mailing Address
First Line : 830 N 2000 W
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062-4047
Country : US
Telephone Number : 801-756-3511
Fax Number : 801-443-1164
Provider Business Practice Location Address
First Line : 830 N 2000 W
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062-4047
Country : US
Telephone Number : 801-756-3511
Fax Number : 801-443-1164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 05/01/2013

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Directions to “ DR. THAD JOSEPH BARKDULL M.D.” Practice Location

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