Basic Information
Provider Information
NPI: 1013985522
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAHOON
FirstName: DANIEL
MiddleName: VERNON
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1055 N 300 W
Address2: STE 316
City: PROVO
State: UT
PostalCode: 846043344
CountryCode: US
TelephoneNumber: 8013577530
FaxNumber: 8013577566
Practice Location
Address1: 1055 N 300 W
Address2: STE 316
City: PROVO
State: UT
PostalCode: 846043344
CountryCode: US
TelephoneNumber: 8013577530
FaxNumber: 8013577566
Other Information
ProviderEnumerationDate: 03/09/2006
LastUpdateDate: 03/13/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208800000X5002338-1205UTY Allopathic & Osteopathic PhysiciansUrology 

No ID Information.


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