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NPI Code Detail

MEDICARE: DR. GEORGE WILLIAM MIDDLETON JR. M.D.

MEDICARE:  DR. GEORGE WILLIAM MIDDLETON JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician9701495NC

General Provider Information

NPI Number : 1376581140
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE WILLIAM MIDDLETON JR. M.D.
Provider Business Mailing Address
First Line : 3725 W 4100 S
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84120-5411
Country : US
Telephone Number : 801-965-3600
Fax Number :
Provider Business Practice Location Address
First Line : 3725 W 4100 S
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84120-5411
Country : US
Telephone Number : 801-965-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 11/29/2021

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Directions to “ DR. GEORGE WILLIAM MIDDLETON JR. M.D.” Practice Location

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