Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 142233-9922 | UT |
Y | 213EG0000X | General Practice | 142233-9922 | UT |
NPI | 1003922196 |
---|---|
Provider Name | Gregory G. Oman |
First Address | Bountiful, UT 84010 |
Second Address | Bountiful, UT 84010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/07/2007 |