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Individual

ROY ALLEN GOODART

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4400 S 700 E, STE 200, SALT LAKE CITY, UT 84107-3000
(801) 264-4444
(801) 281-2383
Mailing address
4400 S 700 E, STE 200, SALT LAKE CITY, UT 84107-3000
(801) 264-4444
(801) 281-2383

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
1595111205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0049543
MT
01
107005361101
IHC
UT
01
22686096009
CIGNA PPO
UT
01
2686096009
CIGNA OPEN ACCESS PLUS
UT
01
3264
PEHP
UT
Enumeration date
05/27/2005
Last updated
07/08/2007
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