Individual
MR. ROBERT CHAD BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5121 S COTTONWOOD ST, STE 950, MURRAY, UT 84107-5701
(801) 507-3462
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-3462
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8782678-1206
UT
363AS0400X
Surgical Physician Assistant
8782678-1206
UT
Other
Enumeration date
09/12/2013
Last updated
04/15/2026
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