Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 7949488-1205 | UT |
NPI | 1043335300 |
---|---|
Provider Name | Chad W Tingey |
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 | 19/03/2007 |
Last Update Date | 17/01/2017 |