SEAN ANTHONY PONCE M.D. NPI 1376577049

NPI Information

Sean Anthony Ponce, M.D. is an addiction medicine family medicine in Salt Lake City, UT with 24 years of experience. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. Sean Anthony Ponce, M.D. NPI is 1376577049. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2000

The provider's business location address is:

3802 S 700 E
SALT LAKE CITY, UT
ZIP 84106-182
Phone: (801) 264-6004
Fax: (801) 264-6098

The NPI 1376577049 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 4/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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