Individual
DR. TODD STANLEY MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 E 200 N, PANGUITCH, UT 84759-0389
(435) 676-8811
(435) 676-2679
Mailing address
PO BOX 389, PANGUITCH, UT 84759-0389
(435) 676-8811
(435) 676-2679
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30991171205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D3477
ID #
UT
Enumeration date
08/23/2006
Last updated
07/08/2007
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