MEDICARE: MARC PAUL HYDE 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
1	207P00000X	Emergency Medicine Physician	355644-1205	UT
2	207P00000X	Emergency Medicine Physician	26154	NE

General Provider Information

NPI Number	:	1962594879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC PAUL HYDE MD

Provider Business Mailing Address
First Line	:	2637 E SPRING HOLLOW DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-4036
Country	:	US
Telephone Number	:	801-910-1905
Fax Number	:

Provider Business Practice Location Address
First Line	:	2637 E SPRING HOLLOW DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-4036
Country	:	US
Telephone Number	:	801-910-1905
Fax Number	:

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	03/07/2023

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Directions to “ MARC PAUL HYDE MD” Practice Location

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