Doctor Name: | MR. SEAN L. WEBSTER |
NPI Number: | 1063759215 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 8482017-1206 |
Business Practice Address: | 557 W 2600 S Bountiful, UT - 840107717 |
Business Phone Number: | 8012989155 |
Business Fax Number: | |
Mailing Address: | 557 W 2600 S, BOUNTIFUL |
State: | UT |
Postal Code: | 840107717 |
Phone Number: | 8012989155 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2013 |
NPI Last Update Date: | 08/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 8482017-1206 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |