DR. DOUGLAS J WIRTHLIN (NPI# 1609816602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609816602 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS J WIRTHLIN |
| Credential | MD |
| Practice Address |
5323 S. Woodrow Street #102 Murray UT 84107 |
| Practice Telephone | 8017131010 |
| Practice Fax Number | 8017130665 |
| Mailing Telephone | 8017131010 |
| Mailing Fax Number | 8017130665 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2012-05-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
5258288-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | D4834 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104389576 | Douglas Wirthlin | Behavior Technician | 515 S 700 E Ste 2a, Salt Lake City, UT 84102-2855 | 2019-04-11 |
| Street Address |
5323 S. WOODROW STREET #102 |
| City | MURRAY |
| State | UT |
| Zip Code | 84107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023019346 | Greg R. Goodman | Surgery | 5323 S. Woodrow Street, #102, Murray, UT 84107 | 2005-08-09 |
| 1063452050 | Steven W Merrell | Surgery | 5323 S. Woodrow Street, #102, Murray, UT 84107 | 2006-06-07 |
| 1598733586 | Spencer W Galt | Surgery | 5323 S. Woodrow Street, #102, Murray, UT 84107 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346507456 | Evan Robert Brownie | Surgery | 5323 S Woodrow St Ste 101, Murray, UT 84107-5843 | 2012-04-13 |
| 1023019346 | Greg R. Goodman | Surgery | 5323 S. Woodrow Street, #102, Murray, UT 84107 | 2005-08-09 |
| 1306376751 | Ihc Health Services Inc | Surgery | 5323 S Woodrow St Ste 101, Murray, UT 84107-5843 | 2017-06-19 |
| 1831407147 | Brad Tanner | Surgery | 5323 Woodrow St Ste 102, Murray, UT 84107-5853 | 2010-09-21 |
| 1215058011 | Matthew Guyon Whitten | Surgery | 5444 S. Green St., Murray, UT 84123-5632 | 2007-04-02 |
| 1467562504 | Craig West Wilkinson | Surgery | 5979 S Fashion Blvd, Murray, UT 84107-7364 | 2006-08-30 |
| 1063452050 | Steven W Merrell | Surgery | 5323 S. Woodrow Street, #102, Murray, UT 84107 | 2006-06-07 |
| 1598733586 | Spencer W Galt | Surgery | 5323 S. Woodrow Street, #102, Murray, UT 84107 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802352 | Usa Vascular Centers of Utah LLC | Surgery | 3479 W 4800 S Ste A, Roy, UT 84067-9429 | 2020-08-18 |
| 1801110531 | Jesse Perry | Surgery | 777 Old Ranch Rd, Park City, UT 84098-6714 | 2010-03-24 |
| 1518293323 | Lakeview Internal Medicine, LLC | Surgery | 444 W Bourne Cir Ste 101, Farmington, UT 84025-3657 | 2009-10-29 |
| 1235398645 | Grant Bryan Erickson | Surgery | Dept Vascular Surgey, 30 North 1900 East, Room 3c 344 Som, Salt Lake City, UT 84132-0001 | 2008-06-02 |
| 1144498163 | Faheem Akhtar | Surgery | 3903 Harrison Blvd., Suite 100, Ogden, UT 84403-2361 | 2008-02-12 |
| 1437347770 | Summit Laser Medical Arts, LLC | Surgery | 2952 Caitland Ct, Salt Lake City, UT 84121-7018 | 2007-10-11 |
| 1033215686 | Peter E Jensen | Surgery | 7410 S Creek Rd Ste 104, Sandy, UT 84093-6151 | 2006-09-14 |
| 1790719219 | Mark D Morasch | Surgery | 1160 E 3900 S Ste 3500, Salt Lake City, UT 84124-1264 | 2006-07-10 |
| 1407854821 | Harrison M Lazarus | Surgery | 3584 W 9000 S, Ste 400, West Jordan, UT 84088-5710 | 2005-07-09 |
| 1225640717 | Usa Vein Clinics of Utah LLC | Surgery | 6028 S Ridgeline Dr, Ogden, UT 84405-6914 | 2020-08-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.