Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 5133249-1205 | UT |
NPI | 1265522874 |
---|---|
Provider Name | Dr. Steven Ross Mobley |
First Address | Murray, UT 84123-2958 |
Second Address | Murray, UT 84123-2958 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 15/11/2016 |