Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 187694-1205 | UT |
NPI | 1841380466 |
---|---|
Provider Name | William Bradford Rockwell |
First Address | Salt Lake City, UT 84158-0049 |
Second Address | Salt Lake City, UT 84132-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 16/11/2021 |