# TOOELE ORTHOPEDICS & SPORTS MEDICINE SPECIALISTS

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

## Provider details

- **NPI number:** 1467581173
- **Authorized official:** JOHN A DOUGLAS M.D. (PRESIDENT)
- **Authorized official phone:** (435) 833-9180

## Contact information

- **Practice address:** 2321 N 400 E STE 300, TOOELE, UT 84074-3440
- **Practice address phone:** (435) 833-9180
- **Practice address fax:** (435) 833-9177
- **Mailing address:** 2321 N 400 E STE 300, TOOELE, UT 84074-3440
- **Mailing address phone:** (435) 833-9180
- **Mailing address fax:** (435) 833-9177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 5617074-1204 | UT | Yes |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 09/12/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | D5620 | — | UT |