Healthcare Provider Details

I. General information

NPI: 1518169929
Provider Name (Legal Business Name): OGDEN ORTHOPAEDIC SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 W GORDON AVE SUITE 2
LAYTON UT
84041-8769
US

IV. Provider business mailing address

4403 HARRISON BLVD SUITE 2600
OGDEN UT
84403-3271
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-2600
  • Fax: 801-387-2625
Mailing address:
  • Phone: 801-387-2600
  • Fax: 801-387-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number51866291205
License Number StateUT

VIII. Authorized Official

Name: JAMES W ADAMS
Title or Position: PRESIDENT
Credential: MD
Phone: 801-387-2600