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Individual

BRENT SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
391 S CHIPETA WAY STE C, SALT LAKE CITY, UT 84108-1294
(801) 581-4800
Mailing address
391 S CHIPETA WAY STE C, SALT LAKE CITY, UT 84108-1294
(801) 581-4800

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
10421634-1205
UT

Other

Enumeration date
04/04/2016
Last updated
07/19/2019
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