Individual provider · NPI-1

Dalton Marshall Beeson, DO

Family Medicine · Provo, UT

NPI number1215738554
StatusActive
Last updated in NPPESOct 19, 2026

Details

NPI
1215738554
Entity type
Individual (NPI-1)
Name
Dalton Marshall Beeson
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
Mar 22, 2025
Certification date
Oct 19, 2026
Last updated
Oct 19, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine14310466-1204UTYes

Practice location

475 W 940 N
Provo, UT 84604-3301

Phone 801-357-7930

Mailing address

475 W 940 N
Provo, UT 84604-3301

Phone 801-357-7930

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