Individual
BRIAN GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3550 N. UNIVERSITY AVE. #250, PROVO, UT 84604
(801) 374-9625
(801) 374-9690
Mailing address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6685
(801) 374-9625
(801) 374-9690
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35108
CO
208600000X
Surgery Physician
7656872-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01351089
—
CO
Enumeration date
09/14/2006
Last updated
09/27/2021
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