Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 6631A | WY |
NPI | 1003287970 |
---|---|
Provider Name | Dr. Marlene Hyndman |
First Address | Bountiful, UT 84010-8204 |
Second Address | Bountiful, UT 84010-8204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2015 |
Last Update Date | 16/10/2015 |