Healthcare Provider Details

I. General information

NPI: 1730252180
Provider Name (Legal Business Name): JAMES REX BRYNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5770 S 250 E G-45
MURRAY UT
84107-8100
US

IV. Provider business mailing address

5770 S 250 E G-45
MURRAY UT
84107-8100
US

V. Phone/Fax

Practice location:
  • Phone: 801-267-9607
  • Fax: 801-268-9652
Mailing address:
  • Phone: 801-267-9607
  • Fax: 801-268-9652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number4187
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: