Organization
BRIAN J WILLIAMS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JEFFERY WILLIAMS MD (OWNER)
(801) 313-1010
Entity
Organization
Contact information
Practice address
602 FORT UNION BLVD, 2ND FLOOR, MIDVALE, UT 84047-2216
(801) 313-1010
(801) 747-2116
Mailing address
602 FORT UNION BLVD, 2ND FLOOR, MIDVALE, UT 84047-2216
(801) 313-1010
(801) 747-2116
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
5322538-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235162199
—
UT
01
—
D5439
MEDICAID LICENSE NUMBER
UT
Enumeration date
03/19/2008
Last updated
09/16/2019
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