# PROVAS OF OGDEN, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073170031
- **Authorized official:** JOHN HEWETT MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (801) 386-4896

## Contact information

- **Practice address:** 5974 FASHION POINT DR STE 110, SOUTH OGDEN, UT 84403-4712
- **Practice address phone:** (801) 386-4896
- **Mailing address:** 5974 FASHION POINT DR STE 110, SOUTH OGDEN, UT 84403-4712
- **Mailing address phone:** (801) 386-4896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2019
- **Last updated:** 05/24/2019