Ebrainmd, Llc is a Specialist in Bountiful, Utah. Ebrainmd, Llc practices all healthcare services and medical treatments related to Specialist. The NPI Number for Ebrainmd, Llc is 1811167547. The last update date is 2016-04-14.
Ebrainmd, Llc's current location address is 3401 S Highway 89, Bountiful, Utah. You can contact this provider via phone number 8012952438 and fax number 8005581912. The mailing address for Ebrainmd, Llc is 3401 S Highway 89, Bountiful, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Ebrainmd, Llc |
|---|---|
| Address | 3401 S Highway 89, Bountiful, Utah |
| Phone Number | 8012952438 |
| Fax Number | 8005581912 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Clyde Lee Brent |
| Credentials | M.D. |
| Telephone Number | 8012952438 |
NPI Number Detail
| NPI Number | 1811167547 |
|---|---|
| Provider Enumeration Date | 2008-03-10 |
| Last Updated Date | 2016-04-14 |
Provider Mailing Address Detail
| Address | 3401 S Highway 89 |
|---|---|
| City | Bountiful |
| State | Utah (UT) |
| Post Code | 840108517 |
| Phone Number | 8012952438 |
| Fax Number | 8005581912 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 6555A |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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What is the unique identifier code issued to Ebrainmd, Llc by the Centers for Medicare & Medicaid Services (CMS)?
The Ebrainmd, Llc has been assigned the NPI (National Provider Identifier) 1811167547. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Ebrainmd, Llc's facilities are situated?
The facilities of Ebrainmd, Llc are physically located at the following address: 3401 S Highway 89, Bountiful, UT, 840108517.
What is Ebrainmd, Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Ebrainmd, Llc's area of specialization is Specialist, and the corresponding taxonomy code that categorizes this field of practice is 174400000X.
On what date did Ebrainmd, Llc receive its 1811167547 assignment from the Centers for Medicare & Medicaid Services?
The Ebrainmd, Llc was assigned its 1811167547 on 2008-03-10, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Ebrainmd, Llc most recently updated or revised?
The information pertaining to Ebrainmd, Llc, including its address, specialty, and other relevant details, was last updated or revised on 2016-04-14.