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Individual
BRIAN R DAVIS
Active
Individual
BRIAN R DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
172302-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679583470
—
UT
01
—
180043150
RAILROAD MEDICARE
UT
01
—
D0565
MEDICAID LICENSE NUMBER
UT
01
—
DH0042
RRMD GROUP
UT
Enumeration date
08/08/2006
Last updated
06/30/2009
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