# BENJAMIN J KROGH DO PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grantsville Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972696425
- **Authorized official:** BENJAMIN J KROGH D.O. (PRESIDENT)
- **Authorized official phone:** (435) 884-3582

## Contact information

- **Practice address:** 822 EAST MAIN STREET, \#7, GRANTSVILLE, UT 84029
- **Practice address phone:** (435) 884-3582
- **Practice address fax:** (435) 884-3578
- **Mailing address:** 822 EAST MAIN STREET, \#7, GRANTSVILLE, UT 84029
- **Mailing address phone:** (435) 884-3582
- **Mailing address fax:** (435) 884-3578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 8502 | UT | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 10/14/2009