Healthcare Provider Details

I. General information

NPI: 1194105320
Provider Name (Legal Business Name): BRYAN READ WILLIAMS D.O,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 W 800 N
OREM UT
84057-3660
US

IV. Provider business mailing address

4168 N 810 W
PLEASANT GROVE UT
84062-8719
US

V. Phone/Fax

Practice location:
  • Phone: 801-714-6000
  • Fax:
Mailing address:
  • Phone: 808-725-8309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberOP61235398
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberDOS-1819
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberDOS-1819
License Number StateHI
# 4
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number14198547-1234
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: