Individual
DAVID T WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
98 N 1100 E STE 103, AMERICAN FORK, UT 84003-2940
(801) 492-2330
(801) 492-2375
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3510331206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10703135101
IHC
UT
01
—
P00023902
PALMETTO
UT
Enumeration date
06/21/2006
Last updated
06/30/2017
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