Individual
DAVID GORDON LIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 N 500 E, LOGAN, UT 84341-2400
(435) 716-2800
Mailing address
1350 N 500 E, LOGAN, UT 84341-2400
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
7153530-1205
UT
207R00000X
Internal Medicine Physician
7153530-1205
UT
207X00000X
Orthopaedic Surgery Physician
MD46150
TN
Other
Enumeration date
11/03/2008
Last updated
08/13/2024
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