Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 150764-1205 | UT |
NPI | 1154497006 |
---|---|
Provider Name | James W Ogilvie |
First Address | Brighton, UT 84121-9758 |
Second Address | Salt Lake City, UT 84103-4399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 08/07/2007 |