NPI 1487646998 · live from the CMS NPI Registry
Robert B Bourne, MD
Orthopaedic Surgery, Sports Medicine in Salt Lake City, UT. National Provider Identifier 1487646998, active.
NPI record
| NPI | 1487646998 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Orthopaedic Surgery, Sports Medicine 207XX0005X |
| Practice location | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124 |
| Practice phone | 801-262-8486 |
| Mailing address | Po Box 100253, Atlanta, GA 30384 |
| Enumerated | August 19, 2005 |
| Last updated | February 9, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthopaedic Surgery, Sports Medicine primary | 207XX0005X | 180189-1205 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.