Black, Brent Dale

Black, Brent Dale is an individual health care provider with primary practice located at 317 S 450 W Unit D , Springville UT 84663-5838. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Occupational Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Black, Brent Dale can be contacted via phone (435) 830-3772.

Contact Information

Primary practice address
317 S 450 W Unit D Springville UT 84663-5838
Phone: (435) 830-3772
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 170138-1205 Utah
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 170138-1205 Utah

Profile Details

NPI number 1710981279
LBN Legal business name Black, Brent Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2005
Last updated Feb 27th, 2024 - about 2 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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