Susan C Hustad MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

377470-1205 Issued in UT

Legal business name

SUSAN C HUSTAD MD, PC

Practice address

425 E 5350 S
Ste 335
Ogden, UT 84405-6946

Phone

(801) 475-8600

Fax

(801) 475-8686

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Susan C Hustad, MD

Title

President

Phone

(801) 475-8600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1447470893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E 5350 S",
            "address_2": "STE 335",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056946",
            "telephone_number": "801-475-8600",
            "fax_number": "801-475-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 5350 S",
            "address_2": "STE 335",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056946",
            "telephone_number": "801-475-8600",
            "fax_number": "801-475-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN C HUSTAD MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "HUSTAD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-475-8600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "377470-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.