NPI 1104868850

Samuel Lynn Southam, MD

Practitioner Diagnostic Radiology Physician Provo, UT

Practice location

Address: 1034 N 500 W, Provo, UT 84604-3380
Phone: (801) 357-7850
Fax: (801) 357-7626

Registered specialties (2)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 2005-0536 (NM)

Other Radiology providers in Utah →

Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 12285899-1205 (UT)

Registry record

NPI: 1104868850
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Jun 2006
Record last updated: 10 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.