Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 7293324-1205 | UT |
N | 207V00000X | Obstetrician & Gynecologist | MD61187434 | WA |
NPI | 1003892480 |
---|---|
Provider Name | Wesley Boyd Davis |
First Address | Ogden, UT 84405-7144 |
Second Address | Ogden, UT 84405-7144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 21/06/2021 |