Brett Wayne Martindale
Family Doctor - Sports Medicine
4700 Harrison Blvd
Ogden
, Utah 84403-4303
Brett Wayne Martindale
Family Doctor - Sports Medicine
4700 Harrison Blvd
Ogden
, Utah 84403-4303
(801) 475-3301
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Brett Wayne Martindale
- Po Box 5546
- Denver, CO
- Zip : 80217-5546
- Fax : (801) 475-3301
- Phone : (801) 475-3300
Second Address
- Brett Wayne Martindale
- 4700 Harrison Blvd
- Ogden, UT
- Zip : 84403-4303
- Fax : (801) 475-3301
- Phone : (801) 475-3300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 9093263-1205 | UT |
National Provider Identifier
| NPI | 1164860573 |
|---|---|
| Provider Name | Brett Wayne Martindale |
| First Address | Denver, CO 80217-5546 |
| Second Address | Ogden, UT 84403-4303 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/06/2013 |
| Last Update Date | 16/06/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1164860573 | (05) | UT |
| U000098254 | MEDICARE PART B (01) | UT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.