# DESERAE J GOBLE MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407232903
- **Authorized official:** DESERAE GOBLE MD (OWNER)
- **Authorized official phone:** (435) 363-7853

## Contact information

- **Practice address:** 1451 N 200 E STE 250, LOGAN, UT 84341-7570
- **Practice address phone:** (435) 363-7853
- **Practice address fax:** (435) 213-3785
- **Mailing address:** PO BOX 5, MILLVILLE, UT 84326-0005
- **Mailing address phone:** (435) 232-4279
- **Mailing address fax:** (888) 668-5207

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 5010200-1205 | UT | Yes |

## Other

- **Enumeration date:** 08/06/2015
- **Last updated:** 08/31/2021