Individual provider · Type 1 NPI

Timothy Bock Icenogle, MD

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Ogden, UT

NPI number 1285683029 Active

Practice location

4403 Harrison Blvd Ste 3835
Ogden, UT 84403-3331

Call (801) 387-3475 Map

Fax (801) 387-3480

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice locations

  • 3415 W Horizon Ave, Spokane, WA 99208-8493 · (509) 220-1900
  • 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 · (254) 202-2000

Specialties and licenses

TaxonomyCodeLicense
Transplant Surgery Physician 204F00000XMD00026659 (WA)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000XS9004 (TX)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000XMD00026659 (WA)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Primary 208G00000X126770044-1205 (UT)

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician: A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of th…

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About NPI 1285683029

Timothy Bock Icenogle, MD's National Provider Identifier is 1285683029, issued on May 9, 2006. The primary taxonomy on file is Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (208G00000X), and the practice location is in Ogden, UT. The record was last updated on Dec 13, 2022.