NPI 1497721195

Lars Bergeson, MD

Practitioner Family Medicine Physician Providence, UT

Practice location

Address: 382 W 280 N, Providence, UT 84332-9707
Phone: (435) 752-0330
Fax: (435) 755-0922
Mailing address: PO Box 609, Providence, UT 84332-0609

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 170371-1205 (UT)

Other Family Medicine providers in Utah →

Registry record

NPI: 1497721195
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Feb 2006
Record last updated: 9 Nov 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.