NPI 1982933750

Lars Bergeson, M.D., PC

Organisation Point of Service Providence, UT

Practice location

Address: 382 W 280 N, Providence, UT 84332-0609
Phone: (435) 752-0330
Fax: (435) 755-0922
Mailing address: PO Box 609 382 W 280 N, Providence, UT 84332-0609

Authorised official

Name: Lars Bergeson
Title: Owner
Phone: (435) 752-0330

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

Other Point of Service providers in Utah →

Registry record

NPI: 1982933750
Entity type: Organization
NPI issued: 8 Dec 2009
Record last updated: 8 Dec 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.