Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 5672741-1205 | UT |
N | 207PE0004X | Emergency Medical Services | 5672741-1205 | UT |
NPI | 1043271026 |
---|---|
Provider Name | Thomas Macfarlane |
First Address | Salt Lake City, UT 84102-1907 |
Second Address | West Jordan, UT 84088-8812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 04/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D5730 | (05) | UT |
I06385 | (02) | UT |