LEENHAPONG NAVARAVONG, MD PROVO, UT

Contact Information

LEENHAPONG NAVARAVONG, MD

395 W COUGAR BLVD
PROVO, UT 84604-3311

Phone: 435-357-4600
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Clinical Cardiac Electrophysiology	207RC0001X	11	Physician/Internal Medicine
Cardiovascular Disease	207RC0000X	11	Physician/Internal Medicine
Internal Medicine	207R00000X	11	Physician/Internal Medicine
Student in an Organized Health Care Education/Training Program	390200000X

Indicates primary specialty

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NPI Profile & details for LEENHAPONG NAVARAVONG · (Male)

NPI Number	`1396937363`
Status	Active
Credentials	MD
Entity	Individual
Enumeration date	08/14/2007
Last updated	06/21/2023 - About 3 years ago
Sole proprietor ¹	No
Identifiers	IA License # 42118 IA License # MD-42118 UT License # 8237582-1205 IA Medicaid 1396937363 IA Other P01437247 RR MEDICARE
Hospital affiliation(s)	MEMORIAL HOSPITAL SWEETWATER COUNTY - (Acute Care) 1200 COLLEGE DRIVE ROCK SPRINGS, WY 82901 UNIVERSITY HEALTH CARE/UNIV HOSPITALS AND CLINICS - (Acute Care) 50 NORTH MEDICAL DRIVE SALT LAKE CITY, UT 84132 WILLIAM BEE RIRIE HOSPITAL - (Critical Access) 1500 AVENUE H ELY, NV 89301

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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LEENHAPONG NAVARAVONG, MD – NPI #1396937363Clinical Cardiac Electrophysiology

Contact Information

Specialty

Clinical Cardiac Electrophysiology

Cardiovascular Disease

Internal Medicine

Student in an Organized Health Care Education/Training Program

NPI Profile & details for LEENHAPONG NAVARAVONG · (Male)

Reviews for LEENHAPONG NAVARAVONG

LEENHAPONG NAVARAVONG, MD – NPI #1396937363
Clinical Cardiac Electrophysiology