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
Phone: (801) 253-3080
Fax: (801) 253-0772
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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