Individual
DR. CHARLES THOMAS IVESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5957 FASHION POINT DR STE 103, SOUTH OGDEN, UT 84403-5180
(385) 492-4930
(385) 492-4449
Mailing address
PO BOX 150627, OGDEN, UT 84415-0627
(385) 492-4930
(385) 492-4449
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
349313-1205
UT
207RP1001X
Pulmonary Disease Physician
Primary
349313-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376585372
—
UT
Enumeration date
06/12/2006
Last updated
08/18/2025
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