Individual
RANDAL BOYD GIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 S WOODLAND HILLS DR, WOODLAND HILLS, UT 84653-2030
(801) 372-8314
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
1650121205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-00362
UNITED HEALTHCARE
UT
01
—
107006654103
IHC
UT
01
—
233116
ALTIUS
UT
01
—
36245
DMBA
UT
01
—
81445
PEHP
UT
01
—
870281028RG2
EMIA
UT
01
—
P00215615
PALMETTO
UT
Enumeration date
09/02/2006
Last updated
07/08/2020
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