| Doctor Name: | DR. GEOFFREY LEO EWING |
| NPI Number: | 1205824216 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 02002552A |
| Business Practice Address: | 7321 11th St Bld 569 Hill Afb, UT - 840565012 |
| Business Phone Number: | 8017774710 |
| Business Fax Number: | |
| Mailing Address: | 1273 N 1450 E, LAYTON |
| State: | UT |
| Postal Code: | 840402957 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 02002552A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |