Organization · NPI-2

Brigham Medical Clinic, INC.

Family Medicine · Brigham City, UT

NPI number1922119528
StatusActive
Last updated in NPPESNov 25, 2009

Details

NPI
1922119528
Entity type
Organization (NPI-2)
Legal business name
Brigham Medical Clinic, INC.
Organization subpart
No
Enumeration date
Aug 31, 2006
Last updated
Nov 25, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine175715-1205UTYes
207Q00000X Family Medicine151481-1205UT
207Q00000X Family Medicine151559-1205UT
207Q00000X Family Medicine160903-1205UT
207R00000X Internal Medicine163362-1205UT
207R00000X Internal Medicine185588-1205UT

Practice location

600 W Hospital Rd
Brigham City, UT 84302-3006

Phone 435-734-2041 · Fax 435-723-8028

Mailing address

Po Box 719
Brigham City, UT 84302-0719

Phone 435-734-2041 · Fax 435-723-8028

Authorized official

Annette Dickamore
Assistant Office Manager
4357342041

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