# BRIAN R DAVIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1679583470
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 172302-1205 | UT | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 06/30/2009

## 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 |