Sean Anthony Ponce
Family Doctor - Addiction Medicine
3802 S 700 E
Salt Lake City
, Utah 84106-1182
Sean Anthony Ponce
Family Doctor - Addiction Medicine
3802 S 700 E
Salt Lake City
, Utah 84106-1182
(801) 264-6098
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About
Features
Specialties
- Family Doctor - Addiction Medicine
Languages spoken
- English
Location
First Address
- Sean Anthony Ponce
- 3802 S 700 E
- Salt Lake City, UT
- Zip : 84106-1182
- Fax : (801) 264-6098
- Phone : (801) 264-6004
Second Address
- Sean Anthony Ponce
- 3802 S 700 E
- Salt Lake City, UT
- Zip : 84106-1182
- Fax : (801) 264-6098
- Phone : (801) 264-6004
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0401X | Family Doctor - Addiction Medicine | 4976571-1205 | UT |
National Provider Identifier
| NPI | 1376577049 |
|---|---|
| Provider Name | Sean Anthony Ponce |
| First Address | Salt Lake City, UT 84106-1182 |
| Second Address | Salt Lake City, UT 84106-1182 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/07/2006 |
| Last Update Date | 29/04/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1376577049 | (05) | UT |
| H52035 | (02) | UT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.