Burdett, Brent Ray

Burdett, Brent Ray is an individual health care provider with primary practice located at 5929 Fashion Point Dr Ste 101, South Ogden UT 84403-4672. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Burdett, Brent Ray can be contacted via phone (801) 476-0052.

Contact Information

Primary practice address
5929 Fashion Point Dr Ste 101 South Ogden UT 84403-4672
Phone: (801) 476-0052
Fax: (801) 476-0064
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 75-158533-1205 Utah

Profile Details

NPI number 1750383097
LBN Legal business name Burdett, Brent Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Jun 23rd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750383097 NPPES
Other 030001482 RAILROAD MEDICARE

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