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NPI Code Detail

MEDICARE: DOUGLAS T SHEPHERD MD

MEDICARE: DOUGLAS T SHEPHERD 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
1208100000XPhysical Medicine & Rehabilitation Physician2253871205UT

General Provider Information

NPI Number : 1659482289
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS T SHEPHERD MD
Provider Business Mailing Address
First Line : PO BOX 5546
Second Line :
City : DENVER
State : CO
Zip : 80217-5546
Country : US
Telephone Number : 801-475-3500
Fax Number :
Provider Business Practice Location Address
First Line : 1916 LAYTON HILLS PKWY 250
Second Line :
City : LAYTON
State : UT
Zip : 84041-5723
Country : US
Telephone Number : 801-479-0312
Fax Number : 801-479-3364
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 09/09/2019

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Directions to “ DOUGLAS T SHEPHERD MD” Practice Location

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