Individual provider · Type 1 NPI

Samuel Lynn Southam, MD

Diagnostic Radiology Physician · Provo, UT

NPI number 1104868850 Active

Practice location

1034 N 500 W
Provo, UT 84604-3380

Call (801) 357-7850 Map

Fax (801) 357-7626

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician 2085R0202X12285899-1205 (UT)
Diagnostic Radiology Physician Primary 2085R0202X2005-0536 (NM)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1104868850

Samuel Lynn Southam, MD's National Provider Identifier is 1104868850, issued on Jun 10, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Provo, UT. The record was last updated on Jun 10, 2021.