Affleck, David Gordon
Affleck, David Gordon is an individual health care provider with primary practice located at 1160 E 3900 S Suite 3500, Salt Lake City UT 84124-1202. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Affleck, David Gordon can be contacted via phone (801) 743-4750.Contact Information
Primary practice address
1160 E 3900 S Suite 3500
Salt Lake City UT 84124-1202
Phone: (801) 743-4750
Fax: (801) 743-4765
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 346120-1206 | Utah |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 3461201205 | Utah |
Profile Details
| NPI number | 1710979653 |
|---|---|
| LBN Legal business name | Affleck, David Gordon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Jan 26th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710979653 | NPPES |
| Utah | MEDICAID | D5506 | |
| Utah | Other | P00424176 | |
| Utah | Other | 134332141 |
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