Healthcare Provider Details

I. General information

NPI: 1437416500
Provider Name (Legal Business Name): BRICE J. WILLIAMS, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4403 HARRISON BLVD. STE-3600
OGDEN UT
84403-3285
US

IV. Provider business mailing address

4403 HARRISON BLVD. STE-3600
OGDEN UT
84403-3285
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-3550
  • Fax: 801-387-3555
Mailing address:
  • Phone: 801-387-3550
  • Fax: 801-387-3555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number7471494-1205
License Number StateUT

VIII. Authorized Official

Name: MARK PASKETT
Title or Position: PRACTICE MANAGER
Credential: MBA
Phone: 801-387-3556