Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carl William Bacon, MD

Individual provider Orthopaedic Surgery Physician · NPI 1962505750

Carl William Bacon, MD is an Orthopaedic Surgery Physician in Provo, Utah. Licensed in Utah. Registered with an NPI since 2006.

Licensed in
UT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1055 N 500 W Ste 121
Provo, UT 84604-3305
Phone: (801) 373-7350
Fax: (801) 812-5401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 181471-1205 (UT)

Record details

NPI number1962505750
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 7, 2006
Last updated in NPPESNovember 27, 2023
Certification dateMarch 20, 2020
Mailing address1055 N 500 W, Credentialing Department, Provo, UT 84604-3305

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