Roy J Gandolfi (NPI# 1740211101, PAC ID# 4486634482) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1740211101 |
| PAC ID by PECOS | 4486634482 |
| Professional Enrollment ID | I20040721000838 |
| Full Name | Roy J Gandolfi |
| Organization Legal Name | GRANGER MEDICAL CLINIC INC |
| Address |
12391 S 4000 Riverton UT 84096-7012 |
| Phone Number | 8013021700 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MICHIGAN MEDICAL SCHOOL |
| Graduation Year | 1981 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 3476465691 |
| Number of Group Practice Members | 159 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460051 | JORDAN VALLEY MEDICAL CENTER |
| 460010 | INTERMOUNTAIN MEDICAL CENTER |
| 460047 | ST MARK'S HOSPITAL |
| 460058 | RIVERTON HOSPITAL |
| 460009 | UNIVERSITY OF UTAH HOSPITALS AND CLINICS |
| Address | Phone | Organization |
|---|---|---|
| 12391 S 4000, Riverton, UT 84096-7012 | 8013021700 | GRANGER MEDICAL CLINIC INC |
| 3725 W 4100, West Valley City, UT 84120-5530 | 8019653600 | GRANGER MEDICAL CLINIC INC |
| Organization Legal Name | GRANGER MEDICAL CLINIC INC |
| Physicians | 158 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Javier Eduardo Chavez | Obstetrics/gynecology | Granger Medical Clinic Inc | 3181 S 9000, West Jordan, UT 84088 |
| Ginette I Speed | Nurse Practitioner | Granger Medical Clinic Inc | 181 E 5600, Suite 130, Murray, UT 84107-6127 |
| Casey J Henich | Family Medicine | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Jared H Mathis | Physician Assistant | Granger Medical Clinic Inc | 2326 N 400 E, C203, Tooele, UT 84074-3408 |
| David George Dienhart | Internal Medicine | Granger Medical Clinic Inc | 71 E 1280, Tooele, UT 84074-8120 |
| Melisa S Steele | Nurse Practitioner | Granger Medical Clinic Inc | 1121 E 3900, Suite C130 Millcreek, Salt Lake City, UT 84124-1200 |
| Robert D Williams | Family Medicine | Granger Medical Clinic Inc | 1288 W 12700, Riverton, UT 84065-6794 |
| Ian R Cavin | General Surgery | Granger Medical Clinic Inc | 4252 S Highland Dr, Suite 200, Salt Lake City, UT 84124-2690 |
| Stephen B Devenport | Family Medicine | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Edwin R England | Obstetrics/gynecology | Granger Medical Clinic Inc | 11724 S State St, Draper, UT 84020-7163 |
| Street Address |
12391 S 4000 |
| City | RIVERTON |
| State | UT |
| Zip | 84096-7012 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen B Devenport | Family Medicine | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Bruce R Applegate | Physical Therapy | Registered Physical Therapists, Inc. | 12391 S 4000, Suite 210, Riverton, UT 84096-7035 |
| Alton D Burgett | Obstetrics/gynecology | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Christopher V Hutchison | Obstetrics/gynecology | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Tom Burton | Physical Therapy | Registered Physical Therapists, Inc. | 12391 S 4000, Suite 210, Riverton, UT 84096-7035 |
| Craig H Yerke | Physician Assistant | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Easton D Jackson | Family Medicine | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Carrie Chandler | Nurse Practitioner | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Reid C Harrison | Internal Medicine | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Craig A Coleby | Internal Medicine | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John J Colarusso | Chiropractic | 12571 S Pasture Rd E, Riverton, UT 84096-4814 | |
| Michael James Peterson | Family Medicine | Ihc Health Services Inc | 5541 W 13400, Riverton, UT 84096-5640 |
| Gregory Sharp Daynes | Family Medicine | Ihc Health Services Inc | 5541 W 13400, Riverton, UT 84096-5640 |
| Daniel C Howells | Optometry | 5069 W 13400 S, Suite 400, Riverton, UT 84096-6602 | |
| Teran A Warner | Chiropractic | 5069 W 13400, Suite 100, Herriman, UT 84096-6603 | |
| Leslie Claire Cagle | Physical Therapy | Herriman Physical Therapy PC | 13358 S 5600, Herriman, UT 84096-6789 |
| Paul Hulet | Optometry | 5528 W 13400, Harriman, UT 84096-6919 | |
| Wade Charles Thompson | Chiropractic | 5734 W 13400, Suite 200, Herriman, UT 84096-6953 | |
| Brandon Hansen | Physician Assistant | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Bonnie J Shurtliff | Physician Assistant | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Find all physicians in zip 84096 | |||
| City | RIVERTON |
| Zip Code | 84096 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | RIVERTON + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Roy J Gandolfi.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.