Provider Demographics
NPI:1508600933
Name:VALOR MEDICAL
Entity type:Organization
Organization Name:VALOR MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDRON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:385-205-6618
Mailing Address - Street 1:3500 HARRISON BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2038
Mailing Address - Country:US
Mailing Address - Phone:385-205-6618
Mailing Address - Fax:385-205-6552
Practice Address - Street 1:3500 HARRISON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2038
Practice Address - Country:US
Practice Address - Phone:385-205-6618
Practice Address - Fax:385-205-6552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty