Organization
SHAWN D. MCQUILKIN, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN DAVID MCQUILKIN M.D. (OWNER)
(801) 829-8881
Entity
Organization
Contact information
Practice address
1117 COUNTRY HILLS DR, SUITE #3, OGDEN, UT 84403-2559
(801) 829-8881
(801) 528-3320
Mailing address
1117 COUNTRY HILLS DR, SUITE #3, OGDEN, UT 84403-2559
(801) 829-8881
(801) 528-3320
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
1761771205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1761771205
STATE LICENSE NUMBER
UT
Enumeration date
08/05/2008
Last updated
08/05/2008
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