Boden, Brian T

Boden, Brian T is an individual health care provider with primary practice located at 1975 N State St , Orem UT 84057-2028. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Boden, Brian T can be contacted via phone (801) 714-5000.

Contact Information

Primary practice address
1975 N State St Orem UT 84057-2028
Phone: (801) 714-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1391 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 7060654-1206 Utah

Profile Details

NPI number 1316938673
LBN Legal business name Boden, Brian T
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Jul 25th, 2011 - about 15 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 1316938673 NPPES
Oklahoma MEDICAID 200052790A

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