Organization
BRIGHAM MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNETTE DICKAMORE (ASSISTANT OFFICE MANAGER)
(435) 734-2041
Entity
Organization
Contact information
Practice address
600 W HOSPITAL RD, BRIGHAM CITY, UT 84302-3006
(435) 734-2041
(435) 723-8028
Mailing address
PO BOX 719, BRIGHAM CITY, UT 84302-0719
(435) 734-2041
(435) 723-8028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
151481-1205
UT
207Q00000X
Family Medicine Physician
151559-1205
UT
207Q00000X
Family Medicine Physician
160903-1205
UT
207Q00000X
Family Medicine Physician
Primary
175715-1205
UT
207R00000X
Internal Medicine Physician
163362-1205
UT
207R00000X
Internal Medicine Physician
185588-1205
UT
Other
Enumeration date
08/31/2006
Last updated
11/25/2009
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