MEDICARE: SYDNEY GARDNER

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	207Q00000X	Family Medicine Physician	12081015-4405	UT

General Provider Information

NPI Number	:	1952257503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY GARDNER

Provider Business Mailing Address
First Line	:	715 N 300 W
Second Line	:
City	:	AMERICAN FORK
State	:	UT
Zip	:	84003
Country	:	US
Telephone Number	:	801-227-9862
Fax Number	:

Provider Business Practice Location Address
First Line	:	1446 S PLEASANT GROVE BLVD
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062
Country	:	US
Telephone Number	:	801-785-5100
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ SYDNEY GARDNER ” Practice Location

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