Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 7324045-1205 | UT |
Y | 208600000X | Surgeon | 7324045-1205 | UT |
N | 2086S0122X | Plastic and Reconstructive Surgery | MT184080 | PA |
NPI | 1174737548 |
---|---|
Provider Name | Matthew Jason Hancey |
First Address | Sandy, UT 84094-3763 |
Second Address | Sandy, UT 84094-3763 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 20/07/2009 |