Basic Information
| Provider Information | |||||||||
| NPI: | 1760593313 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRANDT | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 160534 | ||||||||
| Address2: | |||||||||
| City: | CLEARFIELD | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840160534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014790312 | ||||||||
| FaxNumber: | 8014793364 | ||||||||
| Practice Location | |||||||||
| Address1: | 1916 LAYTON HILLS PKWY 250 | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840415723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014790312 | ||||||||
| FaxNumber: | 8014793364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 07/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 1722341205 | UT | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.