Individual
GORDON N STAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7615
(801) 387-7667
Mailing address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7615
(801) 387-7667
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
179909-1205
UT
207Q00000X
Family Medicine Physician
Primary
179909-1205
UT
Other
Enumeration date
08/12/2006
Last updated
11/12/2019
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