Provider Demographics
NPI:1295996700
Name:LABRUM, BARRETT PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:PAUL
Last Name:LABRUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2631 BLACKWALNUT DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341
Mailing Address - Country:US
Mailing Address - Phone:435-213-3710
Mailing Address - Fax:
Practice Address - Street 1:2380 N 400 E
Practice Address - Street 2:
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1756
Practice Address - Country:US
Practice Address - Phone:435-753-7337
Practice Address - Fax:435-750-6779
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7980132-1204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics