Provider Demographics
NPI:1457191124
Name:DOBYNS, DOUGLAS D
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:D
Last Name:DOBYNS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 W 1330 S
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7256
Mailing Address - Country:US
Mailing Address - Phone:801-360-5058
Mailing Address - Fax:
Practice Address - Street 1:614 W 1330 S
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-7256
Practice Address - Country:US
Practice Address - Phone:801-360-5058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist