Basic Information
Provider Information
NPI: 1265403463
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARNER
FirstName: WILLIAM
MiddleName: BENJAMIN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7181 S CAMPUS VIEW DR
Address2:  
City: WEST JORDAN
State: UT
PostalCode: 840844312
CountryCode: US
TelephoneNumber: 8019653505
FaxNumber:  
Practice Location
Address1: 12391 S 4000 W
Address2:  
City: RIVERTON
State: UT
PostalCode: 840967012
CountryCode: US
TelephoneNumber: 8013021700
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/27/2006
LastUpdateDate: 05/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X200101151NCN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VF0040X10718410-1205UTY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery

No ID Information.


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