TIMOTHY BOCK ICENOGLE

OGDEN, UT
NPI1285683029
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
(Licence: UT  126770044-1205)
Additional Taxonomies204F00000X Transplant Surgery
(Licence: WA  MD00026659)
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
(Licence: TX  S9004)
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
(Licence: WA  MD00026659)
Enumeration Date2006-05-09
Last Update Date2022-12-13
Business Address
TIMOTHY BOCK ICENOGLE MD
4403 HARRISON BLVD STE 3835
OGDEN, UT 84403-3331
Phone number: 801-387-3475
Mailing Address
TIMOTHY BOCK ICENOGLE MD
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: