Davis, Brian R

Davis, Brian R is an sole proprietor health care provider with primary practice located at 1325 W South Jordan Pkwy Suite 103, South Jordan UT 84095-9060. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Davis, Brian R can be contacted via phone (801) 253-3080.

Contact Information

Primary practice address
1325 W South Jordan Pkwy Suite 103 South Jordan UT 84095-9060
Fax: (801) 253-0772
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 172302-1205 Utah

Profile Details

NPI number 1679583470
LBN Legal business name Davis, Brian R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 8th, 2006
Last updated Jun 30th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679583470 NPPES
Utah Other D0565 MEDICAID LICENSE NUMBER
Utah Other DH0042 MEDICAID LICENSE NUMBER
Utah Other 180043150 MEDICAID LICENSE NUMBER
Utah MEDICAID 1679583470 MEDICAID LICENSE NUMBER

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