Individual
ANTHONY WAYNE BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5169 S COTTONWOOD ST STE 400, MURRAY, UT 84107-6769
(801) 507-3460
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-3460
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
11275378-1205
UT
2086S0102X
Surgical Critical Care Physician
11275378-1205
UT
2086S0127X
Trauma Surgery Physician
Primary
11275378-1205
UT
Other
Enumeration date
04/13/2011
Last updated
04/13/2026
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