Roger D. Brockbank, M.D. Valid NPI

Individual provider · Family Medicine Physician · Pleasant Grove, UT

NPI

1669463626

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

4778712-1205 (UT)

Sex

Male

Sole proprietor

No

Enumerated

2005-10-31

Last updated

2013-05-01