Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 12385920-1204 | UT |
NPI | 1235491564 |
---|---|
Provider Name | Sarah Beth Ogle |
First Address | Highland, UT 84003-3682 |
Second Address | Orem, UT 84057-6301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 18/11/2021 |