Brigham Young University

NPI #1942276092 in Provo, Utah

Provider Information

NPI Number: 1942276092
Entity Type: Organization
Organization Name: Brigham Young University
Primary Specialty: Point of Service
Enumeration Date: Feb 28, 2006
Last Updated: Jun 16, 2008

Practice Location

Address: 1750 N WYMOUNT TERRACE DR
Address 2: 2300
City: Provo
State: Utah
ZIP Code: 84602-4800
Phone: (801) 422-2771

Authorized Official

Name: DR. D KEITH WILLMORE, M.D.
Title: MEDICAL DIRECTOR
Phone: (801) 422-7443

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Point of Service	305S00000X	Primary

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