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Active NPI 1659554764 Individual Practitioner Male Practitioner

Dr. Milo Lyman Moody , MD

Specialist • Provo, UT

Professional Overview & Biography Verified Profile Summary

Dr. Milo Moody, MD is a registered healthcare professional specializing in Specialist in Provo, UT. Practice services are available at 777 N 500 W under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

777 N 500 W
#104

Provo, UT 846011541

Telephone 8013749299
Fax 8013774220
Associated Practice Facility / Clinic
🏢 Oral Maxillofacial Surgery Pllc Facility NPI 1497838577

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Provo, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 29.0 Yrs
State Avg: 33.4 Yrs
Regional Practice Density
20 Specialists

Practicing in Provo, UT (427 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License UT 148865-1205

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Lynn Bateman , MD

Internal Medicine

NPI 1922083906

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
✅
NPI Profile Active December 12, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location December 12, 2007

Registered at 777 N 500 W, #104, PROVO, UT 846011541 (Tel: 8013749299)

📍
Updated Business Mailing Address December 12, 2007

Registered at 777 N 500 W, #104, PROVO, UT 846011541 (Tel: 8013749299)

👤
Provider Name / Credentials Updated December 12, 2007

Recorded as MILO MOODY, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 12, 2007

Specialist (License #148865-1205 in UT)

🟢
Initial NPI Registration & Enumeration December 12, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1659554764
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 12, 2007
Last Update: December 12, 2007
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

777 N 500 W, #104

Provo, UT 846011541

Phone: 8013749299

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.