Individual
LARRE DEAN EGBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1000 E 100 N, PAYSON, UT 84651-1600
(801) 465-7190
Mailing address
PO BOX 1098, SALEM, UT 84653-1098
(801) 423-3306
(801) 423-3309
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
178379-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09220
—
UT
Enumeration date
08/31/2005
Last updated
10/07/2013
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