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NPI Code Detail

MEDICARE: DR. BRANDON G WINTLE M.D.

MEDICARE:  DR. BRANDON G WINTLE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician3505751205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932122520
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRANDON G WINTLE M.D.
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-387-8100
Fax Number :
Provider Business Practice Location Address
First Line : 1915 W 5950 S
Second Line :
City : ROY
State : UT
Zip : 84067-1454
Country : US
Telephone Number : 801-387-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 06/08/2009

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Directions to “ DR. BRANDON G WINTLE M.D.” Practice Location

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