Healthcare Provider Details

I. General information

NPI: 1740588144
Provider Name (Legal Business Name): MR. BRIGHAM BRETON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BRIG BRETON PA-C

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 N 740 W
OREM UT
84057-2574
US

IV. Provider business mailing address

1517 N 740 W
OREM UT
84057-2574
US

V. Phone/Fax

Practice location:
  • Phone: 801-473-9740
  • Fax:
Mailing address:
  • Phone: 801-373-4760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number14274870-8906
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: