Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 7676044-1205 | UT |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 65463 | GA |
NPI | 1588840102 |
---|---|
Provider Name | Dr. John Alexander Heflin |
First Address | Salt Lake City, UT 84141-3026 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2008 |
Last Update Date | 10/12/2021 |