Individual
THOMAS L GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1034 NORTH 500 WEST, UTAH VALLEY REGIONAL MEDICAL CENTER, PROVO, UT 84604
(801) 507-5248
(801) 733-5618
Mailing address
3340 NORTH CENTER ST #800, LEHI, UT 84043-7406
(801) 990-1911
(801) 990-1912
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
363811-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002082157
—
NV
01
—
107008344102
IHC
UT
05
—
118322200
—
WY
01
—
1502954
UMWA
UT
01
—
36381112001001
BCBS
UT
01
—
64482
PEHP
UT
01
—
682520
DESERET MUTUAL
UT
05
—
772659
—
AZ
01
—
79086
HEALTHY U
UT
05
—
806156600
—
ID
01
—
870545614GAR
EDUCATORS MUTUAL
UT
01
—
PRA05966
MOLINA
UT
01
—
QM0000075886
ALTIUS
UT
Enumeration date
09/27/2006
Last updated
10/16/2012
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