Individual
LYLE M BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3723 W 12600 S, RIVERTON, UT 84065-7295
(801) 507-4384
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-4384
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
7471625-1205
UT
208M00000X
Hospitalist Physician
Primary
7471625-1205
UT
Other
Enumeration date
01/09/2009
Last updated
05/01/2026
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