Provider Demographics
NPI:1265630941
Name:BEECHER, RUSSELL OGDEN (DO)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:OGDEN
Last Name:BEECHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:945 W HOSPITAL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4214
Mailing Address - Country:US
Mailing Address - Phone:435-613-7246
Mailing Address - Fax:435-613-7247
Practice Address - Street 1:945 W HOSPITAL DRIVE
Practice Address - Street 2:SUITE 4
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501
Practice Address - Country:US
Practice Address - Phone:435-613-7246
Practice Address - Fax:435-613-7247
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2007016063208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation