Individual
THOMAS BULLOCK SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6405 S 3000 E STE 300, HOLLADAY, UT 84121-6977
(801) 266-3113
(801) 931-2166
Mailing address
6405 S 3000 E STE 300, HOLLADAY, UT 84121-6977
(801) 266-3113
(801) 931-2166
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
12286299-0501
UT
213E00000X
Podiatrist
T17-2018
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
12286299-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4071953
—
UT
Enumeration date
05/25/2018
Last updated
02/05/2024
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