Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Roger D. Brockbank, MD

Individual provider Family Medicine Physician · NPI 1669463626

Dr. Roger D. Brockbank, MD is a Family Practice in Pleasant Grove, Utah. Graduated from George Washington University School of Medicine in 1998, 28 years ago. Practices with Premier Family Medical, a 84-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
28
Trained at
George Washington University School of Medicine
Licensed in
UT
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

830 N 2000 W
Pleasant Grove, UT 84062-4047
Phone: (801) 756-3511
Fax: (801) 443-1164
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 4778712-1205 (UT)

Record details

NPI number1669463626
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 31, 2005
Last updated in NPPESMay 1, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolGEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1998 (28 years in practice)
Group practice Premier Family Medical — 84 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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