Individual
PHILLIP MARSHALL BROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
435 N MAIN ST, KAYSVILLE, UT 84037-1194
(801) 498-6000
(801) 498-6085
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8699723-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2012
Last updated
05/30/2019
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