Healthcare Provider Details

I. General information

NPI: 1972591790
Provider Name (Legal Business Name): ROBERT H ZIEGLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 CRESTWOOD DR
OGDEN UT
84405-4869
US

IV. Provider business mailing address

PO BOX 5546
DENVER CO
80217-5546
US

V. Phone/Fax

Practice location:
  • Phone: 801-475-3150
  • Fax: 801-475-3151
Mailing address:
  • Phone: 801-475-3150
  • Fax: 801-475-3151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number4806533-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: