Healthcare Provider Details

I. General information

NPI: 1770161259
Provider Name (Legal Business Name): BRIAN STEVEN DAVIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 CORPORATE CIR STE 230
HENDERSON NV
89074-7752
US

IV. Provider business mailing address

3300 N TRIUMPH BLVD STE 500
LEHI UT
84043-6475
US

V. Phone/Fax

Practice location:
  • Phone: 725-235-7883
  • Fax: 860-679-6736
Mailing address:
  • Phone: 801-821-2781
  • Fax: 860-679-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number27856
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: