Healthcare Provider Details

I. General information

NPI: 1942832555
Provider Name (Legal Business Name): BRADY P BARKER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5316 S WOODROW ST STE 200
MURRAY UT
84107-5479
US

IV. Provider business mailing address

5316 S WOODROW ST STE 200
MURRAY UT
84107-5479
US

V. Phone/Fax

Practice location:
  • Phone: 801-747-1020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number
License Number State

VIII. Authorized Official

Name: KATIE BENARD
Title or Position: OFFICE MANAGER
Credential:
Phone: 801-747-1020