Individual provider · NPI-1

Tye B Harrison, D.O.

Family Medicine, Sports Medicine · Brigham City, UT

NPI number1053631069
StatusActive
Last updated in NPPESOct 24, 2023

Details

NPI
1053631069
Entity type
Individual (NPI-1)
Name
Tye B Harrison
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 2, 2010
Certification date
Oct 24, 2023
Last updated
Oct 24, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207QS0010X Family Medicine, Sports Medicine9857371-1204UTYes

Practice location

600 W Hospital Rd
Brigham City, UT 84302-3006

Phone 435-734-2041 · Fax 435-723-8028

Mailing address

2561 S 1560 W Ste B
Woods Cross, UT 84087-2361

Phone 801-505-0821 · Fax 801-505-0803

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