Organization
TOOELE ORTHOPEDICS & SPORTS MEDICINE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A DOUGLAS M.D. (PRESIDENT)
(435) 833-9180
Entity
Organization
Contact information
Practice address
2321 N 400 E STE 300, TOOELE, UT 84074-3440
(435) 833-9180
(435) 833-9177
Mailing address
2321 N 400 E STE 300, TOOELE, UT 84074-3440
(435) 833-9180
(435) 833-9177
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5617074-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D5620
—
UT
Enumeration date
03/06/2007
Last updated
09/12/2024
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