Organization
LEE S. BROADBENT, M.D. APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE S BROADBENT M.D. (PRESIDENT)
(435) 752-7122
Entity
Organization
Contact information
Practice address
550 E 1400 N, SUITE D, LOGAN, UT 84341-2406
(435) 752-7122
(435) 755-9579
Mailing address
550 E 1400 N, SUITE D, LOGAN, UT 84341-2406
(435) 752-7122
(435) 755-9579
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
731556181205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528569442004
—
UT
Enumeration date
02/20/2008
Last updated
04/07/2011
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