Individual
JOSE PEREZ TAMAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
380 N 200 W, SUITE 209, BOUNTIFUL, UT 84010-7079
(801) 298-1300
(801) 296-6199
Mailing address
380 N 200 W, SUITE 209, BOUNTIFUL, UT 84010-7079
(801) 298-1300
(801) 296-6199
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
7197358-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036092616
—
IL
01
—
1003172
DESERET MUTUAL BENEFIT ADMINISTRATORS
UT
01
—
107072555101
SELECTHEALTH
UT
01
—
107072555102
SELECTHEALTH
UT
01
—
10937612600001
BLUE CROSS AND BLUE SHIELD OF UTAH
UT
01
—
10937612601001
BLUE CROSS AND BLUE SHIELD OF UTAH
UT
01
—
1093761264
UNIVERSITY OF UTAH HEALTH PLANS
UT
01
—
P00681087
RR MEDICARE
UT
01
—
P00684779
RR MEDICARE
UT
Enumeration date
05/26/2006
Last updated
03/10/2010
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