Basic Information
Provider Information
NPI: 1700092004
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANTZ
FirstName: DAVID
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD, MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1055 NORTH 500 WEST
Address2: ATTN: CREDENTIALING
City: PROVO
State: UT
PostalCode: 846043305
CountryCode: US
TelephoneNumber: 8013548225
FaxNumber: 8014180941
Practice Location
Address1: 1175 E 50 S STE 221
Address2:  
City: AMERICAN FORK
State: UT
PostalCode: 840032845
CountryCode: US
TelephoneNumber: 8017720775
FaxNumber: 8017721941
Other Information
ProviderEnumerationDate: 05/15/2007
LastUpdateDate: 03/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X2008-00975NCN Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207RG0100X8283082-1205UTY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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