PETER P TAILLAC (NPI# 1467414581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467414581 |
Entity Type | Individual |
Full Name | PETER P TAILLAC |
Credential | MD |
Practice Address |
University of Utah Division of Emergency Medicine 30 North 1900 East Room 1c026 Salt Lake City UT 84132-0001 |
Mailing Address |
3439 Canyon Cove Dr Holladay UT 84121-6335 |
Practice Telephone | 8015812417 |
Mailing Telephone | 8012727606 |
Mailing Fax Number | 8012725399 |
Enumeration Date | 2006-04-04 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
279025-1205 | UT | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
UT | D1205 | 05 |
Street Address |
UNIVERSITY OF UTAH DIVISION OF EMERGENCY MEDICINE 30 NORTH 1900 EAST ROOM 1C026 |
City | SALT LAKE CITY |
State | UT |
Zip Code | 84132-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275162331 | Scott Andrew Rizzi | Student in an Organized Health Care Education/Training Program | 30 North 1900 East Som 4c116, Salt Lake City, UT 84132 | 2020-04-02 |
1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
1366975914 | Jacob Brandenburg | Anesthesiology | School of Medicine 30 North 1900 East Room 3c444, Salt Lake City, UT 84132 | 2017-04-10 |
1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
1912350083 | Gmaan Alzhrani | Student in an Organized Health Care Education/Training Program | 175 N. Medical Drive East , Salt Lake City, UT 84132 | 2016-07-13 |
1831544600 | Drew Goerke | Occupational Therapist | 50 N Medical Drive, Som Room #1r73, Salt Lake City, UT 84132 | 2016-04-29 |
1891179024 | Bong Jik Kim | Student in an Organized Health Care Education/Training Program | 50 North Medical Drive 3c120, Otolaryngology Administration Office, Salt Lake City, UT 84132 | 2015-07-17 |
1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
1689061822 | Ryan Clark | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E Som 3c127, Salt Lake City, UT 84132 | 2015-04-24 |
1649666264 | Kevin Conrad | Anesthesiology | 30 N 1900 E Room 3c444, Salt Lake City, UT 84132 | 2015-04-09 |
Find all providers in zip 84132 |
Taxonomy Code | 207PE0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Emergency Medical Services |
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437437589 | Jeff Johnson Clawson | Emergency Medicine | 139 E South Temple, Suite 500, Salt Lake City, UT 84111-1103 | 2011-07-22 |
1548463508 | Michael D Dowdall | Emergency Medicine | 381 Middle Oak Ln, Salt Lake City, UT 84108-1649 | 2007-06-07 |
1669562419 | Emergency Physicians Integrated Care, LLC | Emergency Medicine | 2500 S State St, Salt Lake City, UT 84115-3110 | 2006-10-13 |
1316967888 | Peter S Lenz | Emergency Medicine | 8th Ave C St, Salt Lake City, UT 84143-0001 | 2006-07-20 |
1033139589 | Kathleen C Besser | Emergency Medicine | 8th Avenue C St, Salt Lake City, UT 84143-0001 | 2006-07-20 |
1578598199 | Emergency Physicians Integrated Care, LLC | Emergency Medicine | 333 N 300 W, Salt Lake City, UT 84103-1215 | 2006-07-12 |
1265689905 | Rocky Mountain Critical Care Associates, Inc | Emergency Medicine | 1050 E South Temple, 3rd Floor, Salt Lake City, UT 84102-1507 | 2008-08-25 |
1194972836 | S Dwayne Roberts Md LLC | Emergency Medicine | 1050 E South Temple, 3rd Floor, Salt Lake City, UT 84102-1507 | 2008-08-25 |
1538182365 | Gregory R Dunnavant | Emergency Medicine | 8th Avenue C St, Salt Lake City, UT 84143-0001 | 2006-07-25 |
1588687495 | Todd L Allen | Emergency Medicine | 8th Avenue C St, Salt Lake City, UT 84143-0001 | 2006-07-25 |
Find all providers in SALT LAKE CITY |
City | SALT LAKE CITY |
Zip Code | 84132 |
Please comment or provide details below to improve the information on PETER P TAILLAC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.