Whalio Doctors

NPI 1285683029

Timothy Bock Icenogle, MD

Practitioner Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Ogden, UT

Practice location

Address
4403 Harrison Blvd STE 3835, Ogden, UT 84403-3331
Phone
(801) 387-3475
Fax
(801) 387-3480
Mailing address
PO Box 27128, Salt Lake City, UT 84127-0128

Registered specialties (4)

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 208G00000X Licence 126770044-1205 (UT)
Transplant Surgery Physician
Allopathic & Osteopathic Physicians Taxonomy 204F00000X Licence MD00026659 (WA)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Allopathic & Osteopathic Physicians Taxonomy 208G00000X Licence S9004 (TX)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Allopathic & Osteopathic Physicians Taxonomy 208G00000X Licence MD00026659 (WA)

Registry record

NPI
1285683029
Entity type
Individual
Sex (as registered)
Male
NPI issued
9 May 2006
Record last updated
13 Dec 2022

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.