Healthcare Provider Details

I. General information

NPI: 1295267896
Provider Name (Legal Business Name): BRIAN THOMAS CAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N 1900 E SOM 3B324
SALT LAKE CITY UT
84132-0002
US

IV. Provider business mailing address

30 N 1900 E SOM 3B324
SALT LAKE CITY UT
84132-0002
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-6803
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number10955775-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number10955775-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: