Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 11780296-1205 | UT |
N | 207XS0117X | Orthopaedic Spine Surgeon | 11780296-1205 | UT |
NPI | 1316365323 |
---|---|
Provider Name | Howard Y. Park |
First Address | Salt Lake City, UT 84108-1200 |
Second Address | Salt Lake City, UT 84108-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 10/02/2022 |