Healthcare Provider Details

I. General information

NPI: 1649568957
Provider Name (Legal Business Name): BRIAN E JAMES AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 N UNIVERSITY AVE
PROVO UT
84604-4438
US

IV. Provider business mailing address

3303 N UNIVERSITY AVE
PROVO UT
84604-4438
US

V. Phone/Fax

Practice location:
  • Phone: 801-373-7438
  • Fax: 801-373-7486
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number8092096-4101
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number8092096-4101
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number8092096-4101
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number8092096-4101
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: