Healthcare Provider Details

I. General information

NPI: 1982651071
Provider Name (Legal Business Name): MARGARET F. ENSIGN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5444 S. GREEN ST.
MURRAY UT
84123-5632
US

IV. Provider business mailing address

5444 S. GREEN ST.
MURRAY UT
84123-5632
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-8120
  • Fax: 801-262-5721
Mailing address:
  • Phone: 801-262-2647
  • Fax: 801-262-3897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number173253-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberM-8438
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: