Provider Demographics
NPI:1174117253
Name:MCWHORTER, COLBY WEST (DO)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:WEST
Last Name:MCWHORTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 GLENDELL DR
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-7569
Mailing Address - Country:US
Mailing Address - Phone:479-427-9066
Mailing Address - Fax:
Practice Address - Street 1:1763 GLENDELL DR
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-7569
Practice Address - Country:US
Practice Address - Phone:479-427-9066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider