Provider Demographics
NPI:1972769917
Name:GUILFOYLE, GREGG MICHAEL (DO)
Entity type:Individual
Prefix:
First Name:GREGG
Middle Name:MICHAEL
Last Name:GUILFOYLE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11762 S STATE ST STE 320
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7166
Mailing Address - Country:US
Mailing Address - Phone:801-702-9191
Mailing Address - Fax:877-326-3388
Practice Address - Street 1:11762 S STATE ST STE 320
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7166
Practice Address - Country:US
Practice Address - Phone:801-702-9191
Practice Address - Fax:877-326-3388
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT118475001204208200000X
UT11847500-1204208200000X
PAOS014237208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery