Provider Demographics
NPI:1972559557
Name:DAYNES, GREGORY SHARP (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SHARP
Last Name:DAYNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5746 W 13400 S
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-6907
Mailing Address - Country:US
Mailing Address - Phone:801-253-4001
Mailing Address - Fax:801-253-4003
Practice Address - Street 1:5746 W 13400 S
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-6907
Practice Address - Country:US
Practice Address - Phone:801-253-4001
Practice Address - Fax:801-253-4003
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT5295308-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTH42692Medicare UPIN
UT005732401Medicare ID - Type Unspecified