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Individual

DR. JAYAPRAKASH MOODALAGIRIAPPA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5121 S COTTONWOOD STREET, INTERMOUNTAIN MEDICAL CENTER, MURRAY, UT 84157
(801) 507-5248
(801) 432-2668
Mailing address
3340 NORTH CENTER ST, #800, LEHI, UT 84043-7406
(801) 990-1911
(801) 990-1912

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
74-156806-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002085089
NV
05
002999200
ID
01
107005021101
IHC
UT
05
107961100
WY
01
1502954
UMWA
UT
01
2090168
UNITED HEALTHCARE
UT
01
35683
DESERET MUTUAL
UT
01
37806
PEHP
UT
01
53245
HEALTHY U
UT
05
857394
AZ
01
8597445
WORKERS COMP FUND
UT
01
870545614JA1
EDUCATORS MUTUAL
UT
01
PRA02897
MOLINA
UT
01
QM0000075886
ALTIUS
UT
Enumeration date
08/25/2006
Last updated
10/15/2012
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