Individual provider · Type 1 NPI

Tracy R. Syddall, PA-C

Medical Physician Assistant · Salt Lake City, UT

NPI number 1205070091 Active

Practice location

1525 W 2100 S
Salt Lake City, UT 84119-1401

Mailing address

10479 S Sage Vista Way
South Jordan, UT 84095-3955

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X7270173-1206 (UT)

Medical Physician Assistant: Definition to come...

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About NPI 1205070091

Tracy R. Syddall, PA-C's National Provider Identifier is 1205070091, issued on Apr 24, 2009. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Salt Lake City, UT. The record was last updated on Dec 13, 2021.