Individual
DR. BRIAN K WHISENANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5169 S COTTONWOOD ST, BLDG. 2, SUITE 520, MURRAY, UT 84107-6767
(801) 507-3500
(801) 507-3550
Mailing address
5169 S COTTONWOOD ST, BLDG. 2, SUITE 520, MURRAY, UT 84107-6767
(801) 507-3500
(801) 507-3550
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
3100162-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002089137
—
NV
05
—
120845400
—
WY
05
—
805966100
—
ID
05
—
D3497
—
UT
01
—
P00210847
RR MEDICARE
—
Enumeration date
03/09/2006
Last updated
09/24/2012
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