Individual
DR. MATTHEW G. OLLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5 E 400 N, SPRINGVILLE, UT 84663-1347
(801) 491-3668
(801) 489-6378
Mailing address
PO BOX 595, SPRINGVILLE, UT 84663-0595
(801) 491-3668
(801) 489-6378
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
370042-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370042-0501
STATE LICENSE
UT
01
—
370042-8907
STATE CONTROLLED SUBSTANC
UT
01
—
4321250001
FEDERAL DME #
UT
05
—
909244
—
AZ
Enumeration date
08/16/2005
Last updated
03/07/2023
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