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General NPI Number Information
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NPI Number | 1316366131
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Entity Type | Organization
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Legal Business Name | SANDRA WHITFIELD M.D.
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 5998 S 2950 E
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City | OGDEN
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State | UT
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Zip | 84403-5476
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Country | US
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Telephone | 801-391-7410
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Fax | 180-175-2193
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Provider Business Mailing Address
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Address Line | 5998 S 2950 E
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City | OGDEN
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State | UT
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Zip | 84403-5476
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Country | US
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Telephone | 801-391-7410
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Fax | 180-175-2193
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SANDRA WHITFIELD
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Credential | M.D.
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Telephone | 801-391-7410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 162621-1205
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License Number State | UT
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