Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 5172031205 | UT |
NPI | 1023031507 |
---|---|
Provider Name | Darren Housel |
First Address | South Ogden, UT 84405 |
Second Address | South Ogden, UT 84405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 06/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122387900 | (05) | WY |
806537000 | (05) | ID |
D4670 | (05) | UT |
F75900 | (02) | UT |