Goble, Deserae Jeanette
Goble, Deserae Jeanette is an individual health care provider with primary practice located at 1451 N 200 E Ste 250 , Logan UT 84341-7570. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Goble, Deserae Jeanette can be contacted via phone (435) 363-7853.Contact Information
Primary practice address
1451 N 200 E Ste 250
Logan UT 84341-7570
Phone: (435) 363-7853
Fax: (435) 213-3785
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A93148 | California |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5010200-1205 | Utah |
Profile Details
| NPI number | 1366415770 |
|---|---|
| LBN Legal business name | Goble, Deserae Jeanette |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Aug 31st, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366415770 | NPPES |
| Utah | MEDICAID | 1366415770 |
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