NPI 1124214374

Lance Dustin Edmonds, MD

Practitioner Diagnostic Radiology Physician Provo, UT

Practice location

Address: 1055 N 500 W STE 112, Provo, UT 84604-3305
Phone: (801) 812-4624
Fax: (801) 812-4699
Mailing address: 1055 N 500 W Attn Credentialing, Provo, UT 84604

Registered specialties (2)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 380515-1205 (UT)

Other Radiology providers in Utah →

Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence A108694 (CA)

Registry record

NPI: 1124214374
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Sep 2007
Record last updated: 20 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.