MEDICARE: DR. WILLIAM BRADFORD HEPWORTH MD

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
1	208D00000X	General Practice Physician	288828-1205	UT

General Provider Information

NPI Number	:	1609830538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM BRADFORD HEPWORTH MD

Provider Business Mailing Address
First Line	:	180 SOUTH 100 WEST, #1049
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-8639
Country	:	US
Telephone Number	:	801-692-1304
Fax Number	:

Provider Business Practice Location Address
First Line	:	9771 N OXFORD CIR
Second Line	:
City	:	CEDAR HILLS
State	:	UT
Zip	:	84062-8639
Country	:	US
Telephone Number	:	801-692-1304
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	05/14/2022

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