David M Fantle, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

3344141205 Issued in UT

Practice address

400 C St
Salt Lake City, UT 84143-1005

Phone

(801) 408-8305

NPI assigned

Jul 15, 2006

Last updated

Mar 18, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bryson S. Smith, MD, PC

  • Neurological Surgery Physician
  • Ogden, UT
  • NPI 1003004672
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1205852613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-408-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 C ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841431005",
            "telephone_number": "801-408-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTLE",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": "3344141205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taniela Ma'U Fangupo
• Angela Marie Fanjul, LCSW
• Michael Fank Jr., NP
• Nathan Richard Fankhauser, PT
• Hanna K. Fanous, MD
• Alecia Farabee
• Lesley Farber, OTR/L
• Arman Farhadtouski, DDS
• Esteban Farias
• Alexa Farillas

• Neurology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Neurology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.