Basic Information
Provider Information
NPI: 1992825384
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAY
FirstName: JOE
MiddleName: T
NamePrefix:  
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5080 SPECTRUM DR
Address2: SUITE 1200W
City: ADDISON
State: TX
PostalCode: 750014648
CountryCode: US
TelephoneNumber: 9723648000
FaxNumber: 2147754516
Practice Location
Address1: 1735 S REDWOOD RD
Address2: SUITE 110 & 115
City: SALT LAKE CITY
State: UT
PostalCode: 841045101
CountryCode: US
TelephoneNumber: 6157784066
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/30/2007
LastUpdateDate: 02/11/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2083X0100X53232721205UTY Allopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine

No ID Information.


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