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

Timothy Bock Icenogle, MD

Individual provider Transplant Surgery Physician · NPI 1285683029

Timothy Bock Icenogle, MD is a Transplant Surgery Physician in Ogden, Utah. Works from 3 locations. Licensed in Texas, Utah and Washington.

Licensed in
TX, UT, WA
In the registry since
2006
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4403 Harrison Blvd Ste 3835
Ogden, UT 84403-3331
Phone: (801) 387-3475
Fax: (801) 387-3480
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

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

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X · Licence 126770044-1205 (UT)
Transplant Surgery Physician Taxonomy 204F00000X · Licence MD00026659 (WA)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence S9004 (TX)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence MD00026659 (WA)

Record details

NPI number1285683029
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 9, 2006
Last updated in NPPESDecember 13, 2022
Certification dateDecember 13, 2022
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128