Healthcare Provider Details

I. General information

NPI: 1003990573
Provider Name (Legal Business Name): DAVID BILLINGS BROWN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 ERRECART BLVD
ELKO NV
89801-8333
US

IV. Provider business mailing address

3750 S 2455 E
SALT LAKE CITY UT
84109-3435
US

V. Phone/Fax

Practice location:
  • Phone: 775-738-5151
  • Fax:
Mailing address:
  • Phone: 801-400-7559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2994
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number342951-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: