Provider Demographics
NPI:1144705583
Name:GASHLER, BRIAN LARRY (PA-C)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:LARRY
Last Name:GASHLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 W 1500 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2994
Mailing Address - Country:US
Mailing Address - Phone:385-985-4368
Mailing Address - Fax:
Practice Address - Street 1:54 N 8TH W
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116
Practice Address - Country:US
Practice Address - Phone:385-985-4368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10999504-1206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine