Individual
DR. BRAD M GOATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
412 N 200 E, LOGAN, UT 84321-4038
(435) 713-2800
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 713-2800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11013846A
IN
Other
Enumeration date
06/28/2007
Last updated
03/01/2012
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