Provider Demographics
NPI:1932188133
Name:ARMSTRONG, JOHN D (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:ARMSTRONG
Suffix:
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 1:4360 WASHINGTON BLVD
Mailing Address - Street 2:ATTN CREDENTIALING
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-1866
Mailing Address - Country:US
Mailing Address - Phone:801-476-0494
Mailing Address - Fax:801-479-3937
Practice Address - Street 1:4360 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-1866
Practice Address - Country:US
Practice Address - Phone:801-476-0494
Practice Address - Fax:801-479-3937
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2018-06-27
Deactivation Date:2018-05-30
Deactivation Code:
Reactivation Date:2018-06-27
Provider Licenses
StateLicense IDTaxonomies
UT1647181205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTC75115Medicare UPIN