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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BRANT WAHLEN FONNESBECK, DO

Active

BRANT WAHLEN FONNESBECK, DO is a Family Medicine healthcare provider located in LOGAN, Utah. NPI 1033156849 is currently active in the NPPES registry. Verify at CMS.

Family Medicine · LOGAN, UT

Registration Details

NPI Number
1033156849
Provider Type
Individual
Gender
Male
NPI Issued
Jun 1, 2006 (20.169209927612 yrs)
Last Updated
Feb 26, 2008
License
5953772-1204 (UT)

Practice Information

Address
550 E 1400 N STE K
LOGAN, UT, 843412450
Browse UT providers · Browse ZIP 84341
Phone
4357556061
Primary Specialty
Family Medicine
207Q00000X

Other Family Medicine Providers in LOGAN, UT

Name Credential NPI
JAMES WALTER DAVIS M.D. 1801878095
DESERAE JEANETTE GOBLE MD 1366415770
DR. MATTHEW JOHN WELTER M.D. 1164486064
JOHN BARRETT MD 1487688552
NATHAN H CALL 1104830884
BRIAN W CARLSON MD 1760498687
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.