Organization
BRIAN W HEATON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN W HEATON MD (PRESIDENT)
(807) 387-4550
Entity
Organization
Contact information
Practice address
4403 HARRISON BLVD, SUITE 4400, OGDEN, UT 84403-3271
(801) 387-4550
(801) 387-4565
Mailing address
4403 HARRISON BLVD, SUITE 4400, OGDEN, UT 84403-3271
(807) 387-4550
(801) 387-4565
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
181028-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528908750009
—
UT
Enumeration date
04/01/2008
Last updated
04/01/2008
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