Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 50030301204 | UT |
NPI | 1003826439 |
---|---|
Provider Name | E Brett Horsley |
First Address | Logan, UT 84341-2400 |
Second Address | Logan, UT 84341-2400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 17/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H57050 | (02) | UT |