Provider Demographics
NPI:1629038963
Name:BROWN, BRYANT J (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYANT
Middle Name:J
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3970 S 700 E
Mailing Address - Street 2:SUITE 14
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2191
Mailing Address - Country:US
Mailing Address - Phone:801-261-3975
Mailing Address - Fax:801-262-9142
Practice Address - Street 1:3970 S 700 E
Practice Address - Street 2:SUITE 14
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2191
Practice Address - Country:US
Practice Address - Phone:801-261-3975
Practice Address - Fax:801-262-9142
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2021-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT263190207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD99481Medicare UPIN