Individual
DR. LARRY CREED FORD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N 500 W, SUITE 202, PROVO, UT 84604-3305
(801) 374-2367
(801) 429-8015
Mailing address
1055 N 500 W, PROVO, UT 84604-3305
(801) 354-8225
(801) 429-8150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
6994485-1205
UT
207RI0200X
Infectious Disease Physician
Primary
6994485-1205
UT
Other
Enumeration date
05/10/2007
Last updated
05/06/2011
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