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Individual

MARK ROBERT GILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 W ANTELOPE DR, LAYTON, UT 84041
(801) 807-1000
Mailing address
3021 CORRAL DR, LAYTON, UT 84040-7448
(801) 444-2551

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
50872591205
UT
207L00000X
Anesthesiology Physician
Primary
MD176903
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D4357
UT
Enumeration date
03/14/2006
Last updated
06/23/2023
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