Healthcare Provider Details

I. General information

NPI: 1063692960
Provider Name (Legal Business Name): THOMAS T DOXEY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

876 12TH ST
OGDEN UT
84404-6400
US

IV. Provider business mailing address

876 12TH ST
OGDEN UT
84404-6400
US

V. Phone/Fax

Practice location:
  • Phone: 801-399-9802
  • Fax: 801-399-9804
Mailing address:
  • Phone: 801-399-9802
  • Fax: 801-399-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number1640821202
License Number StateUT

VIII. Authorized Official

Name: DR. THOMAS T DOXEY
Title or Position: PRESIDENT
Credential: DC
Phone: 801-399-9802