Provider Demographics
NPI:1144263419
Name:VALENTINE, JOHN F (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:FRANKLIN
Other - Last Name:VALENTINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 413033
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84141-3033
Mailing Address - Country:US
Mailing Address - Phone:801-213-3900
Mailing Address - Fax:801-581-7476
Practice Address - Street 1:50 N MEDICAL DR
Practice Address - Street 2:SOM 4R118
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-2410
Practice Address - Country:US
Practice Address - Phone:801-581-7802
Practice Address - Fax:801-581-7476
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8142989-1205207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052571500Medicaid
FL052571500Medicaid
E81518Medicare UPIN