Provider Demographics
NPI:1659617736
Name:DOUGLAS DENYS M.D. P.C.
Entity Type:Organization
Organization Name:DOUGLAS DENYS M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DENYS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-855-2930
Mailing Address - Street 1:1159 E 200 N
Mailing Address - Street 2:SUITE 325
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2022
Mailing Address - Country:US
Mailing Address - Phone:801-855-2930
Mailing Address - Fax:801-855-2934
Practice Address - Street 1:1159 E 200 N
Practice Address - Street 2:SUITE 325
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2022
Practice Address - Country:US
Practice Address - Phone:801-855-2930
Practice Address - Fax:801-855-2934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4802745-1205207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty