Individual
DR. J DAVID SULE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
48 W 1500 N, NEPHI, UT 84648-8900
(435) 623-3200
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221
(208) 758-4100
(208) 782-3752
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
042458
GA
208800000X
Urology Physician
Primary
14001511-1235
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000718891A
—
GA
Enumeration date
11/07/2005
Last updated
02/13/2025
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