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Organization
NATHAN W DAVIS DPM PC
Active
Organization
NATHAN W DAVIS DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THIA HAMBLIN (OFFICE MANAGER)
(801) 743-2909
Entity
Organization
Contact information
Practice address
154 MYRTLE AVE, SUITE 201, MURRAY, UT 84107-4849
(801) 743-2909
(801) 288-9505
Mailing address
154 MYRTLE AVE, SUITE 201, MURRAY, UT 84107-4849
(801) 743-2909
(801) 288-9505
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
49208910501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002189004
MEDICAID NEVADA
UT
01
—
123401800
US DEPT OF LABOR
UT
01
—
2700110
UNITED HEALTH CARE
UT
01
—
418216001
CIGNA MEDICARE
UT
01
—
49208910503001
BLUE CROSS BLUE SHIELD
UT
05
—
528271194007
—
UT
01
—
P00057743
RAILROAD MEDICARE
UT
01
—
QM000061991
ALTIUS
UT
Enumeration date
07/27/2007
Last updated
12/02/2009
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