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

Dr. Eric E. Liedtke, DO

Individual provider Surgery Physician · NPI 1366624330

Dr. Eric E. Liedtke, DO is a General Surgery in Ogden, Utah. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2005, 21 years ago. Practices with Ogden Clinic Specialty Services LLC, a 133-clinician group and accepts Medicare assignment. Licensed in California, Utah and Washington.

Years since qualifying
21
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
CA, UT, WA
In the registry since
2007
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4650 Harrison Blvd
Ogden, UT 84403-4303
Phone: (801) 475-3010
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 12168421-1204 (UT)
Surgery Physician Taxonomy 208600000X · Licence 20A12096 (CA)
Surgery Physician Taxonomy 208600000X · Licence OP60582410 (WA)

Record details

NPI number1366624330
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedDecember 3, 2007
Last updated in NPPESJune 15, 2021
Certification dateJune 15, 2021
Mailing addressPo Box 5546, Denver, CO 80217-5546

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2005 (21 years in practice)
Group practice Ogden Clinic Specialty Services Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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