Individual
DR. TOBY MERRILL ENNISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 N. 1900 EAST, MREB 307, UNIVERSITY OF UTAH SCHOOL OF MEDICINE, DEPT. OF SURGERY, SALT LAKE CITY, UT 84132
(801) 585-7280
(801) 587-9370
Mailing address
30 N. 1900 EAST, MREB 307, UNIVERSITY OF UTAH SCHOOL OF MEDICINE, DEPT. OF SURGERY, SALT LAKE CITY, UT 84132-0001
(801) 585-7280
(801) 587-9370
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
7643802-1205
UT
2086S0102X
Surgical Critical Care Physician
Primary
7643802-1205
UT
2086S0127X
Trauma Surgery Physician
7643802-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7643802-1205
STATE MEDICAL LICENSE
UT
01
—
7643802-8905
STATE CONTROLLED SUBSTANCE NUMBER
UT
Enumeration date
11/03/2007
Last updated
03/07/2023
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