Individual
DR. JAY CAESAR MORELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 W 7200 S STE A, 72ND STREET CLINIC, CHC INC, MIDVALE, UT 84047-1043
(801) 566-5494
(801) 561-9647
Mailing address
220 W 7200 S STE A, 72ND STREET CLINIC, CHC INC, MIDVALE, UT 84047-1043
(801) 566-5494
(801) 561-9647
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
263407-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G06469
—
UT
Enumeration date
12/22/2005
Last updated
12/04/2011
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