Individual
PAUL FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
96 E KIMBALLS LN STE 207, DRAPER, UT 84020-5025
(801) 576-2300
(419) 537-5600
Mailing address
PO BOX 100253, ATLANTA, GA 30384-0253
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2606111205
UT
207X00000X
Orthopaedic Surgery Physician
35062570
OH
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
35062570
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0265449
—
OH
Enumeration date
07/27/2006
Last updated
02/15/2022
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