Individual
MEGAN PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 N 1900 E, SOM RM 4C116, SALT LAKE CITY, UT 84132-0002
(402) 416-1894
Mailing address
30 N 1900 E, SOM RM 4C116, SALT LAKE CITY, UT 84132-0002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10493730-1205
UT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
10493730-1205
UT
Other
Enumeration date
04/19/2016
Last updated
11/12/2021
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