Individual
BARON HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5475 S 500 E, OGDEN, UT 84405-6905
(801) 479-2111
Mailing address
1806 N 400 W, NORTH OGDEN, UT 84414-7292
(801) 388-0832
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10376632-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
10376632-4405
UT
Other
Enumeration date
01/29/2022
Last updated
06/30/2022
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