NPI 1407800311 · live from the CMS NPI Registry
Darrel Scott Brodke, MD
Orthopaedic Surgery in Salt Lake City, UT. National Provider Identifier 1407800311, active.
NPI record
| NPI | 1407800311 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Orthopaedic Surgery 207X00000X |
| Practice location | 590 Wakara Way, Salt Lake City, UT 84108 |
| Practice phone | 801-587-7109 |
| Mailing address | Po Box 413067, Slc, UT 84141 |
| Enumerated | May 22, 2006 |
| Last updated | November 11, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthopaedic Surgery, Orthopaedic Surgery of the Spine | 207XS0117X | 342621-1205 (UT) |
| Orthopaedic Surgery primary | 207X00000X | 342621-1205 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.