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Individual

DR. WILLIAM HARMON TETTELBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
308 E 4500 S STE 100, SALT LAKE CITY, UT 84107-4057
(385) 533-8898
Mailing address
3810 LARIAT RD, PARK CITY, UT 84098-4826
(901) 517-1889

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
351005-1205
UT
207RI0200X
Infectious Disease Physician
MD 37898
TN
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
351005-1205
UT
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
MD37898
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3510051205
UTAH LICENSE
UT
05
3714443
TN
Enumeration date
06/08/2005
Last updated
07/30/2025
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