MEDICARE: BRETT W DOXEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	284609-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386775682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT W DOXEY MD

Provider Business Mailing Address
First Line	:	6360 S 3000 E
Second Line	:	#220
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-6923
Country	:	US
Telephone Number	:	801-944-3144
Fax Number	:	801-944-3186

Provider Business Practice Location Address
First Line	:	3741 W 12600 S
Second Line	:	#470
City	:	RIVERTON
State	:	UT
Zip	:	84065-7215
Country	:	US
Telephone Number	:	801-727-4280
Fax Number	:	801-254-8331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	06/09/2015

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