NPI 1063680668 · live from the CMS NPI Registry
Douglas Clark Flegal, DPM
Podiatrist, Foot & Ankle Surgery in Salt Lake City, UT. National Provider Identifier 1063680668, active.
NPI record
| NPI | 1063680668 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 740 E 3900 S, Suite 108, Salt Lake City, UT 84107 |
| Practice phone | 801-266-3113 |
| Enumerated | February 15, 2008 |
| Last updated | August 28, 2012 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Primary Podiatric Medicine | 213EP1101X | 102232-0501 (UT) |
| Podiatrist, Radiology | 213ER0200X | 102232-0501 (UT) |
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 102232-0501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.