Individual
MARTIN H MEMMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
960 W 800 N, OREM, UT 84057-3626
(801) 226-6184
Mailing address
960 W 800 N, OREM, UT 84057-3626
(801) 226-6184
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6853842-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500690161
—
OR
Enumeration date
01/25/2008
Last updated
07/07/2026
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