Individual
BENJAMIN NORDBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
395 W COUGAR BLVD STE 205, PROVO, UT 84604-3328
(801) 357-1770
(801) 357-1779
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-1770
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7724308-1205
UT
Other
Enumeration date
06/26/2008
Last updated
06/04/2025
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