Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 274407-1205 | UT |
N | 207RH0003X | Hematology & Oncology | 04-25846 | KS |
N | 207RH0003X | Hematology & Oncology | 108812 | MO |
Y | 207RX0202X | Medical Oncology | 274407-1205 | UT |
NPI | 1093787541 |
---|---|
Provider Name | William T. Stephenson II |
First Address | Salt Lake City, UT 84124-1297 |
Second Address | Provo, UT 84604-3334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 24/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F19715 | (02) | MO |
P00729479 | (02) | KS |