Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4681 | SD |
N | 208600000X | Surgeon | 4681 | SD |
Y | 2086S0120X | Pediatric Surgery | 10975405-1204 | UT |
NPI | 1013986157 |
---|---|
Provider Name | Lee Dupont Trotter |
First Address | Orem, UT 84057-3660 |
Second Address | Orem, UT 84057-3660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 25/08/2021 |