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Red Tyde
Medical Physician Assistant in Hyde Park, Utah
NPI 1679156004

Red Tyde is a Medical Physician Assistant based in Woods Cross, UT and is specialized in Medical. Red Tyde practices in Hyde Park, UT. The NPI Number for Red Tyde is 1679156004 and holds a License No. (Utah).

The current practice location address for Red Tyde is 3935 N 75 W, Hyde Park, UT and can be reached out via phone at 435-994-2665.

Location: 3935 N 75 W, Hyde Park, UT, 84087-2361
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1679156004
Provider Name
Red Tyde
Credential
Provider Entity Type
Organization
Address
3935 N 75 W, Hyde Park, UT, 84087-2361
Phone Number
435-994-2665
Fax Number
Provider Enumeration Date
05/03/2021
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
3935 N 75 W
City
Hyde Park
State
Utah
Zip
84318-4111
Phone Number
435-994-2665
Fax Number
person
Provider Business Mailing Address Details
Address
3935 N 75 W
City
Hyde Park
State
Utah
Zip
84318-4111
Phone Number
435-994-2665
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
()
Definition
Definition to come...
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