Provider Demographics
NPI:1972834174
Name:KLOMP, GREGORY FOULGER (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:FOULGER
Last Name:KLOMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8830 PARLEYS LN
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5125
Mailing Address - Country:US
Mailing Address - Phone:917-622-4894
Mailing Address - Fax:
Practice Address - Street 1:8830 PARLEYS LN
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5125
Practice Address - Country:US
Practice Address - Phone:917-622-4894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9048690-1205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine