# BRIGHAM MEDICAL CLINIC, INC.

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

## Provider details

- **NPI number:** 1922119528
- **Authorized official:** MRS. ANNETTE DICKAMORE (ASSISTANT OFFICE MANAGER)
- **Authorized official phone:** (435) 734-2041

## Contact information

- **Practice address:** 600 W HOSPITAL RD, BRIGHAM CITY, UT 84302-3006
- **Practice address phone:** (435) 734-2041
- **Practice address fax:** (435) 723-8028
- **Mailing address:** PO BOX 719, BRIGHAM CITY, UT 84302-0719
- **Mailing address phone:** (435) 734-2041
- **Mailing address fax:** (435) 723-8028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 151481-1205 | UT | — |
| 207Q00000X | Family Medicine Physician | 151559-1205 | UT | — |
| 207Q00000X | Family Medicine Physician | 160903-1205 | UT | — |
| 207Q00000X | Family Medicine Physician | 175715-1205 | UT | Yes |
| 207R00000X | Internal Medicine Physician | 163362-1205 | UT | — |
| 207R00000X | Internal Medicine Physician | 185588-1205 | UT | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 11/25/2009