Dr. James Wallentine Blotter
Plastic Surgeon (Head & Neck)
2380 N 400 E Suite #d
North Logan
, Utah 84341-1749
Dr. James Wallentine Blotter
Plastic Surgeon (Head & Neck)
2380 N 400 E Suite #d
North Logan
, Utah 84341-1749
(435) 753-5845
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About
Features
Specialties
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Dr. James Wallentine Blotter
- 2380 N 400 E Suite #d
- North Logan, UT
- Zip : 84341-1749
- Fax : (435) 753-5845
- Phone : (435) 753-7880
Second Address
- Dr. James Wallentine Blotter
- 2380 N 400 E Suite #d
- North Logan, UT
- Zip : 84341-1749
- Fax : (435) 753-5845
- Phone : (435) 753-7880
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 3082587-1205 | UT |
National Provider Identifier
| NPI | 1962499673 |
|---|---|
| Provider Name | Dr. James Wallentine Blotter |
| First Address | North Logan, UT 84341-1749 |
| Second Address | North Logan, UT 84341-1749 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/09/2005 |
| Last Update Date | 09/10/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 87037196400 | (05) | UT |
| BB5162716 | DEA (01) | UT |
| H10552 | (02) | UT |
| M-8784 | IDAHO STATE LICENSE (01) | ID |
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.