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Individual
ANTHONY WAYNE BACON
Active
Individual
ANTHONY WAYNE BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
11275378-1205
UT
2086S0102X
Surgical Critical Care Physician
11275378-1205
UT
2086S0127X
Trauma Surgery Physician
Primary
11275378-1205
UT
Other
Enumeration date
04/13/2011
Last updated
04/13/2026
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