Provider Demographics
NPI:1760743421
Name:DAVID H. WORKMAN, M.D., P.C.
Entity Type:Organization
Organization Name:DAVID H. WORKMAN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-446-1742
Mailing Address - Street 1:1214 SUN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-6196
Mailing Address - Country:US
Mailing Address - Phone:801-446-1742
Mailing Address - Fax:801-446-3773
Practice Address - Street 1:1214 SUN RIVER DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-6196
Practice Address - Country:US
Practice Address - Phone:801-446-1742
Practice Address - Fax:801-446-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1786741205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000012761OtherMEDICARE ID
UT000012761OtherMEDICARE ID