Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DAVID GORDON LIDDLE, MD
ActiveSports Medicine (EM) · LOGAN, UT
Registration Details
- NPI Number
- 1922251982
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 3, 2008 (17.4661522103 yrs)
- Last Updated
- Aug 13, 2024
- Licenses
-
7153530-1205 (UT)MD46150 (TN)7153530-1205 (UT)
Practice Information
- Address
-
1350 N 500 ELOGAN, UT, 843412400Browse UT providers · Browse ZIP 84341
- Phone
- 4357162800
- Primary Specialty
-
Sports Medicine (EM)
207PS0010X
- Additional Specialty
- Orthopaedic Surgery
- Additional Specialty
- Sports Medicine (EM)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.