Keller, Bruce Weaver

Keller, Bruce Weaver is an individual health care provider with primary practice located at 600 W Hospital Rd , Brigham City UT 84302-3006. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Keller, Bruce Weaver can be contacted via phone (435) 734-2041.

Contact Information

Primary practice address
600 W Hospital Rd Brigham City UT 84302-3006
Phone: (435) 734-2041
Fax: (435) 723-8028
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 151481-1205 Utah

Profile Details

NPI number 1427169036
LBN Legal business name Keller, Bruce Weaver
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Nov 25th, 2009 - about 16 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 1427169036 NPPES
Utah MEDICAID 04192

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