Provider Demographics
NPI:1235341793
Name:HART, BRANDON JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:JAY
Last Name:HART
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4401 HARRISON BLVD
Mailing Address - Street 2:DEPARTMENT OF NEONATOLOGY
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-3195
Mailing Address - Country:US
Mailing Address - Phone:801-387-4300
Mailing Address - Fax:801-387-4306
Practice Address - Street 1:4401 HARRISON BLVD
Practice Address - Street 2:DEPARTMENT OF NEONATOLOGY
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-3195
Practice Address - Country:US
Practice Address - Phone:801-387-4300
Practice Address - Fax:801-387-4306
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2021-09-16
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Provider Licenses
StateLicense IDTaxonomies
UT9610363-89052080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine