Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 200101151 | NC |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 10718410-1205 | UT |
NPI | 1265403463 |
---|---|
Provider Name | Dr. William Benjamin Warner |
First Address | West Jordan, UT 84084-4312 |
Second Address | Riverton, UT 84096-7012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 06/05/2020 |