Individual
GREGORY J ALLRED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
560 W 465 N STE 604, PROVIDENCE, UT 84332-8006
(435) 753-1600
(453) 753-9521
Mailing address
560 W 465 N STE 604, PROVIDENCE, UT 84332-8006
(435) 753-1600
(453) 753-9521
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
007990
AZ
207L00000X
Anesthesiology Physician
Primary
02007233A
IN
207L00000X
Anesthesiology Physician
Primary
11176335-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225415854
—
UT
05
—
300078348
—
IN
01
—
M22404299
MEDICARE PTAN
IN
Enumeration date
05/04/2015
Last updated
06/17/2026
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