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Individual

DR. THOMAS R AUSTAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1885 WEST 4400 SOUTH, ROY, UT 84067
(801) 731-3833
(801) 731-4561
Mailing address
1885 WEST 4400 SOUTH, ROY, UT 84067
(801) 731-3833
(801) 731-4561

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1026230501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
756480226
RR MEDICARE
01
870341157
TAX ID
Enumeration date
09/20/2006
Last updated
02/08/2008
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