Individual
DR. RODNEY GILLMAN JAY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2292
Mailing address
450 E MAIN ST, REXBURG, ID 83440-2048
(208) 356-3691
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
5298339-1205
UT
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
M-12527
ID
207PS0010X
Sports Medicine (Emergency Medicine) Physician
5298339-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225201148
—
UT
Enumeration date
04/11/2008
Last updated
02/04/2026
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