Healthcare Provider Details

I. General information

NPI: 1689968844
Provider Name (Legal Business Name): BRIAN CHRISTOPHER NYBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 N MAIN ST
CEDAR CITY UT
84721-5129
US

IV. Provider business mailing address

732 N MAIN ST
CEDAR CITY UT
84721-5129
US

V. Phone/Fax

Practice location:
  • Phone: 435-800-1011
  • Fax: 435-383-5781
Mailing address:
  • Phone: 435-800-1011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9357053-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number9357053-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number67752
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberU8901
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number67752
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: