Provider Demographics
NPI:1427350552
Name:JEFFREY C MARGETTS, MD, PC
Entity type:Organization
Organization Name:JEFFREY C MARGETTS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARGETTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-264-9521
Mailing Address - Street 1:1250 E 3900 S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1348
Mailing Address - Country:US
Mailing Address - Phone:801-264-9521
Mailing Address - Fax:801-261-2562
Practice Address - Street 1:1250 E 3900 S
Practice Address - Street 2:SUITE 200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1348
Practice Address - Country:US
Practice Address - Phone:801-264-9521
Practice Address - Fax:801-261-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT178472-1205207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT520663354047Medicaid
UTC63847Medicare UPIN
UT000010904Medicare PIN