Provider Demographics
NPI:1073948683
Name:BROWNING, DAVID GLEN (PA-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GLEN
Last Name:BROWNING
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 E RIDGELINE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-4976
Mailing Address - Country:US
Mailing Address - Phone:801-399-3324
Mailing Address - Fax:801-394-2807
Practice Address - Street 1:1495 E RIDGELINE DR
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-4976
Practice Address - Country:US
Practice Address - Phone:801-399-3324
Practice Address - Fax:801-394-2807
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8763157-1206363A00000X, 363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical