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General NPI Number Information
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NPI Number | 1396107595
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Entity Type | Individual
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Provider Name | BRIAN BERRETT MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2016
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 2183 W MAIN ST STE A209
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City | LEHI
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State | UT
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Zip | 84043-6760
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Country | US
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Telephone | 801-406-6256
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Fax |
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Provider Business Mailing Address
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Address Line | 2183 W MAIN ST STE A209
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City | LEHI
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State | UT
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Zip | 84043-6760
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Country | US
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Telephone | 801-406-6256
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Fax | 859-545-4978
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 12365803-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A155219
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License Number State | CA
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