Individual
DR. BLAKE J BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
(877) 594-2787
Mailing address
630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
174216-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D1025
—
UT
Enumeration date
08/12/2006
Last updated
04/18/2008
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