Basic Information
Provider Information
NPI: 1013947845
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAUMAN
FirstName: THOMAS
MiddleName: D.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 27128
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841270128
CountryCode: US
TelephoneNumber: 8015358163
FaxNumber: 8013554011
Practice Location
Address1: 333 S 900 E
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841022310
CountryCode: US
TelephoneNumber: 8015358163
FaxNumber: 8013554011
Other Information
ProviderEnumerationDate: 07/04/2006
LastUpdateDate: 03/19/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X165202-1205UTY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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