Healthcare Provider Details

I. General information

NPI: 1265575849
Provider Name (Legal Business Name): DAVID C. BOORMAN, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 S 900 E SUITE 107
SAINT GEORGE UT
84790-7000
US

IV. Provider business mailing address

736 S 900 E SUITE 107
SAINT GEORGE UT
84790-7000
US

V. Phone/Fax

Practice location:
  • Phone: 435-634-8383
  • Fax: 435-634-1324
Mailing address:
  • Phone: 435-634-8383
  • Fax: 435-634-1324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID C BOORMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 435-634-8383