NPI 1770825713 · live from the CMS NPI Registry
Brandon Thomas Dickinson, M.D.
Internal Medicine, Gastroenterology in Provo, UT. National Provider Identifier 1770825713, active.
NPI record
| NPI | 1770825713 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Gastroenterology 207RG0100X |
| Practice location | 1055 N 500 W Ste 100, Provo, UT 84604 |
| Practice phone | 801-374-1268 |
| Mailing address | 1055 N 500 W, Attn Credentialing, Provo, UT 84604 |
| Enumerated | March 17, 2013 |
| Last updated | November 27, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Gastroenterology | 207RG0100X | MD60587041 (WA) |
| Internal Medicine, Gastroenterology primary | 207RG0100X | 11676583-1205 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.