person
Brian K. Penrose, DPM
Foot & Ankle Surgery Podiatrist in Logan, Utah
NPI 1437508116

Brian K. Penrose is a Foot & Ankle Surgery Podiatrist based in Logan, UT and is specialized in Foot & Ankle Surgery. Brian K. Penrose practices in Logan, UT and has the professional credentials of DPM. The NPI Number for Brian K. Penrose is 1437508116 and holds a License No. 07001313A (Utah).

The current practice location address for Brian K. Penrose is 1350 N 500 E, Logan, UT and can be reached out via phone at . You can also correspond with Brian K. Penrose through the mailing address at 1350 N 500 E, LOGAN, UT - 84341-2400 (mailing address contact number: 435-716-2800).

Location: 1350 N 500 E, Logan, UT, 84341-2400
person
Provider Profile Details
NPI Number
1437508116
Provider Name
Brian K. Penrose
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
1350 N 500 E, Logan, UT, 84341-2400
Phone Number
Fax Number
Provider Enumeration Date
06/03/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
13232441-0501 01 UT UTAH MEDICAL LICENSE
000001366840 01 IN ANTHEM
738460022 01 IN MEDICARE
41000341A 01 IN IN MEDICAL LICENSE
IN1933075 01 IN MEDICARE
000001293859 01 IN ANTHEM
201375910 05 IN
institution
Provider Business Practice Location Address Details
Address
1350 N 500 E
City
State
Zip
84341-2400
Phone Number
Fax Number
person
Provider Business Mailing Address Details
Address
1350 N 500 E
City
State
Zip
84341-2400
Phone Number
435-716-2800
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
07001313A (Indiana)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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