Provider Demographics
NPI:1386714459
Name:DOXEY, TODD THOMAS (DC, MPH)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:THOMAS
Last Name:DOXEY
Suffix:
Gender:M
Credentials:DC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 29TH ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-4243
Mailing Address - Country:US
Mailing Address - Phone:801-394-9450
Mailing Address - Fax:801-866-0033
Practice Address - Street 1:4013 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:UT
Practice Address - Zip Code:84405-1511
Practice Address - Country:US
Practice Address - Phone:801-394-9450
Practice Address - Fax:801-866-0033
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT345031-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTQM0000026401OtherALTIUS
UT870395551DO4OtherEDUCATORS MUTUAL
UT48453OtherPUBLIC EMPLY HEALTH PLAN
UT0000056183Medicare ID - Type UnspecifiedMEDICARE
UTQM0000026401OtherALTIUS