Provider Demographics
NPI:1659329449
Name:WORKMAN, DAVID H IX (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:WORKMAN
Suffix:IX
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 W 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:801-309-1476
Mailing Address - Fax:
Practice Address - Street 1:1214 W 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:801-309-1476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1786741205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTE03487Medicare UPIN
UT000012761Medicare ID - Type Unspecified