1518169929 NPI number — OGDEN ORTHOPAEDIC SPECIALISTS, LLC

Table of content: (NPI 1518169929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518169929 NPI number — OGDEN ORTHOPAEDIC SPECIALISTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OGDEN ORTHOPAEDIC SPECIALISTS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518169929
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4403 HARRISON BLVD
Provider Second Line Business Mailing Address:
SUITE 2600
Provider Business Mailing Address City Name:
OGDEN
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84403-3271
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-387-2600
Provider Business Mailing Address Fax Number:
801-387-2625

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3225 W GORDON AVE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
LAYTON
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84041-8769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-387-2600
Provider Business Practice Location Address Fax Number:
801-387-2625
Provider Enumeration Date:
06/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
801-387-2600

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  51866291205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com