DARYL RAY EZIDORE (NPI# 1902291842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902291842 |
| Entity Type | Individual |
| Full Name | DARYL RAY EZIDORE |
| Practice Address |
100 South 344 East Salt Lake City UT 84101 |
| Mailing Address |
5636 S 3650 W Taylorsville UT 84129-3661 |
| Practice Telephone | 8013223222 |
| Mailing Telephone | 8017555415 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
100 SOUTH 344 EAST |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053804237 | Holly Smith | Registered Nurse | 1020 S Main Street, Salt Lake City, UT 84101 | 2018-06-12 |
| 1174999627 | Justin Williams | Social Worker | 155 W. 300 S., Salt Lake City, UT 84101 | 2015-08-19 |
| 1104190859 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 50 S Main St Ste 115, Salt Lake City, UT 84101 | 2012-02-28 |
| 1366713307 | Gonstead Family Chiropractic | Chiropractor | 1154 S. 300 W., Suite C, Salt Lake City, UT 84101 | 2012-01-23 |
| 1659544880 | Jeffrey Daniel | Registered Nurse | 404 South 400 West, Salt Lake City, UT 84101 | 2008-04-09 |
| 1306030580 | Christopher Dean Chapman | Chiropractor | 345 W 100 S Ste 6c, Salt Lake City, UT 84101 | 2007-08-30 |
| 1689713497 | Walter Landon Bye | Dentist | 15 West South Temple, Gateway Tower West Suite 440, Salt Lake City, UT 84101 | 2007-02-06 |
| 1154403152 | Allison Miller Gardner | Physical Therapist | 84 West 700 South, Salt Lake City, UT 84101 | 2006-10-19 |
| 1780655407 | Frederick Van Der Veur | Social Worker | 1020 South Main Street, 242, Salt Lake City, UT 84101 | 2006-01-30 |
| 1801872718 | Anthony L Lee | Nurse Practitioner | 155 S 300 W, Salt Lake City, UT 84101 | 2005-12-22 |
| Find all providers in zip 84101 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205829 | Brittany Nicole Beverly | Student in an Organized Health Care Education/Training Program | 236 N Sun Arbor Ter Apt 2111, Salt Lake City, UT 84116-4537 | 2020-11-06 |
| 1508484023 | Courtney Hook | Student in an Organized Health Care Education/Training Program | 1860 E 250 S Hper East, Room 208, Salt Lake City, UT 84112 | 2020-07-10 |
| 1669090502 | Kelly Maree Gutpell | Student in an Organized Health Care Education/Training Program | 81 N Mario Capecchi Dr Ste 1a.011, Salt Lake City, UT 84113-1125 | 2020-07-07 |
| 1134744014 | Scarlet Reyes | Student in an Organized Health Care Education/Training Program | 25 S 1100 E Apt 14, Salt Lake City, UT 84102-1514 | 2020-06-16 |
| 1215553151 | Andrew Winn Bringhurst | Student in an Organized Health Care Education/Training Program | 1737 E Imperial Park Sq, Salt Lake City, UT 84106-5104 | 2020-06-16 |
| 1134744287 | Jillian G Barker | Student in an Organized Health Care Education/Training Program | 1345 S 400 E, Salt Lake City, UT 84115-1548 | 2020-06-15 |
| 1114542255 | Gustavo Carrillo | Student in an Organized Health Care Education/Training Program | 1652 W 800 S, Salt Lake City, UT 84104-3112 | 2020-06-15 |
| 1982229035 | Cristhian V. Toruno | Student in an Organized Health Care Education/Training Program | 448 N 1100 W, Salt Lake City, UT 84116-2649 | 2020-06-15 |
| 1144845108 | Huong T Pham | Student in an Organized Health Care Education/Training Program | 319 E Beldon Pl, Salt Lake City, UT 84111-3516 | 2020-06-15 |
| 1790300754 | Krista Huffaker | Student in an Organized Health Care Education/Training Program | 1212 E 500 S # 2, Salt Lake City, UT 84102-3223 | 2020-06-15 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84101 |
Please comment or provide details below to improve the information on DARYL RAY EZIDORE.
| 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.