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General NPI Number Information
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NPI Number | 1700883600
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Entity Type | Individual
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Provider Name | RANDALL DEAN BARNETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 5405 S 500 E SUITE 101
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City | OGDEN
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State | UT
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Zip | 84405-6957
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Country | US
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Telephone | 801-689-3500
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Fax | 801-689-3505
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Provider Business Mailing Address
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Address Line | 5405 S 500 E SUITE 101
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City | OGDEN
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State | UT
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Zip | 84405-6957
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Country | US
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Telephone | 801-689-3500
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Fax | 801-689-3505
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 94-272450-1250
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License Number State | UT
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